MEDICARE: AHMED ABDELRAHMAN 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	208600000X	Surgery Physician	0	TX
2	2084P0800X	Psychiatry Physician	306146-01	NY

General Provider Information

NPI Number	:	1497288682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AHMED ABDELRAHMAN MD

Provider Business Mailing Address
First Line	:	5323 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-7201
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 E 68TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10065-4870
Country	:	US
Telephone Number	:	212-746-5822
Fax Number	:

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

Provider Enumeration Date	:	04/05/2017
Last Update Date	:	01/24/2023

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