Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 258711 | NY |
NPI | 1407060866 |
---|---|
Provider Name | Tamer Ahmed |
First Address | Syracuse, NY 13210-1603 |
Second Address | Syracuse, NY 13210-1603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 18/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03267085 | (05) | NY |