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General NPI Number Information
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NPI Number | 1578693917
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Entity Type | Organization
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Legal Business Name | AHMAD M. MEHDI M.D P.C
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 01/16/2020
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Provider Practice Location Address
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Address Line | 100 SYKES ST
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City | GROTON
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State | NY
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Zip | 13073-1231
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Country | US
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Telephone | 607-898-5827
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Fax | 607-898-9726
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Provider Business Mailing Address
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Address Line | 100 SYKES ST PO BOX 68
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City | GROTON
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State | NY
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Zip | 13073-1231
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Country | US
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Telephone | 607-898-5827
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Fax | 607-898-9726
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Authorized Official
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Title or Position | DR
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Name | DR. AHAMD M. MEHDI
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Credential | M.D
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Telephone | 607-898-5827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 007106-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 215330-1
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License Number State | NY
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