MEDICARE: DR. MOHAMMAD N AHSAN M.D.

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	237185	NY
2	207P00000X	Emergency Medicine Physician	237185	NY

General Provider Information

NPI Number	:	1891753000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMMAD N AHSAN M.D.

Provider Business Mailing Address
First Line	:	9002 QUEENS BLVD
Second Line	:
City	:	ELMHURST
State	:	NY
Zip	:	11373-4941
Country	:	US
Telephone Number	:	718-558-1078
Fax Number	:	718-558-3916

Provider Business Practice Location Address
First Line	:	9002 QUEENS BLVD
Second Line	:
City	:	ELMHURST
State	:	NY
Zip	:	11373-4941
Country	:	US
Telephone Number	:	718-558-1078
Fax Number	:	718-558-3916

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

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	02/02/2009

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