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General NPI Number Information
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NPI Number | 1114063930
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Entity Type | Individual
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Provider Name | MAIRAJ AHMED D.D.S., M.S.
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Gender | Male
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 08/13/2012
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Provider Practice Location Address
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Address Line | 918 PELHAM PKWY S #3
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City | BRONX
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State | NY
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Zip | 10462-1144
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Country | US
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Telephone | 718-684-3131
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Fax | 718-684-3132
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Provider Business Mailing Address
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Address Line | 918 PELHAM PKWY S #3
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City | BRONX
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State | NY
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Zip | 10462-1144
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Country | US
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Telephone | 718-684-3131
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Fax | 718-684-3132
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 051790
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License Number State | NY
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