MEDICARE: DR. AHMAD M MEHDI MD

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	207Q00000X	Family Medicine Physician	2153301	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CFP/2153302	OTHER	NY	COMPENSATION CODE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	000024791	OTHER	NY	BCBS

General Provider Information

NPI Number	:	1427037159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AHMAD M MEHDI MD

Provider Business Mailing Address
First Line	:	505 STATE ROUTE 281
Second Line	:
City	:	TULLY
State	:	NY
Zip	:	13159
Country	:	US
Telephone Number	:	315-696-7304
Fax Number	:	315-696-5251

Provider Business Practice Location Address
First Line	:	505 STATE ROUTE 281
Second Line	:
City	:	TULLY
State	:	NY
Zip	:	13159-2547
Country	:	US
Telephone Number	:	315-696-7304
Fax Number	:	315-696-5251

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

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	01/05/2026

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