=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265939805
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NISHAT TASNIM AHMED MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/10/2018
-----------------------------------------------------
Last Update Date | 10/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 201 CEDAR ST SE STE 5600 OBSTETRICS AND GYNEOCOLOGY
-----------------------------------------------------
City | ALBUQUERQUE
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 87106-4920
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 505-563-6000
-----------------------------------------------------
Fax | 505-563-6060
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 26666 PRESBYTERIAN HEALTHCARE SERVICE
-----------------------------------------------------
City | ALBUQUERQUE
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 87125-6666
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 505-272-5580
-----------------------------------------------------
Fax | 505-272-6385
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NM
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207VF0040X
-----------------------------------------------------
Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
-----------------------------------------------------
License Number | MD2024-0842
-----------------------------------------------------
License Number State | NM
-----------------------------------------------------