MEDICARE: DR. NADEEM AHMED M.D.,M.P.H.

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	207R00000X	Internal Medicine Physician	237916-1	NY

General Provider Information

NPI Number	:	1255499190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NADEEM AHMED M.D.,M.P.H.

Provider Business Mailing Address
First Line	:	21 TOWNLEY AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-5635
Country	:	US
Telephone Number	:	718-698-8018
Fax Number	:	718-982-1625

Provider Business Practice Location Address
First Line	:	2102 KINGS HWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1537
Country	:	US
Telephone Number	:	718-253-6660
Fax Number	:	718-951-6584

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

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	07/08/2007

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