Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | 240578-1 | NY |
Y | 2084N0400X | Neurologist | 240578 | NY |
NPI | 1831517002 |
---|---|
Provider Name | Omar Ahmed |
First Address | New York, NY 10028-0912 |
Second Address | New York, NY 10028-0912 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2014 |
Last Update Date | 12/09/2017 |