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General NPI Number Information
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NPI Number | 1275437162
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Entity Type | Organization
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Legal Business Name | SHAWON AHMED PHYSICIAN ASSISTANT PLLC
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 3608 29TH ST APT 4L
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City | ASTORIA
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State | NY
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Zip | 11106-3247
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Country | US
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Telephone | 917-607-7091
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Fax |
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Provider Business Mailing Address
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Address Line | 3608 29TH ST APT 4L
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City | ASTORIA
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State | NY
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Zip | 11106-3247
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT/OWNER
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Name | SHAWON AHMED
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Credential | PA
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Telephone | 917-607-7091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State | NULL
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