Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156F00000X | Technician/Technologist |
NPI | 1275825481 |
---|---|
Provider Name | Irfan Ahmed |
First Address | Stamford, CT 06902-2920 |
Second Address | Brooklyn, NY 11234-2920 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2011 |
Last Update Date | 13/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
139269 | ARDMS (01) | |
NX86579T | (05) | NY |