MEDICARE: KAMOL KANU AHMED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1083446611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAMOL KANU AHMED

Provider Business Mailing Address
First Line	:	6240 JOE KLUTSCH DR
Second Line	:
City	:	FORT WASHINGTON
State	:	MD
Zip	:	20744-1974
Country	:	US
Telephone Number	:	202-263-9220
Fax Number	:

Provider Business Practice Location Address
First Line	:	6240 JOE KLUTSCH DR
Second Line	:
City	:	FORT WASHINGTON
State	:	MD
Zip	:	20744-1974
Country	:	US
Telephone Number	:	202-263-9220
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2024
Last Update Date	:	08/14/2024

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Directions to “ KAMOL KANU AHMED ” Practice Location

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