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NPI Code Detail

MEDICARE: AHMAD ALTAJAR MD

MEDICARE: AHMAD ALTAJAR 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
1207R00000XInternal Medicine PhysicianP141366NY

General Provider Information

NPI Number : 1720926744
Entity Type Code : Individual
Provider Name (Legal Business Name) : AHMAD ALTAJAR MD
Provider Business Mailing Address
First Line : 190 SCOFIELD AVE # 2
Second Line :
City : BRIDGEPORT
State : CT
Zip : 06605-2925
Country : US
Telephone Number : 203-522-9010
Fax Number :
Provider Business Practice Location Address
First Line : 6355 BROADWAY
Second Line :
City : BRONX
State : NY
Zip : 10471-2701
Country : US
Telephone Number : 718-549-3300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2026
Last Update Date : 03/23/2026

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