Provider Demographics
NPI:1487712618
Name:AHMED, MAHJABEEN (MD)
Entity type:Individual
Prefix:DR
First Name:MAHJABEEN
Middle Name:
Last Name:AHMED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 LILAC CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-7007
Mailing Address - Country:US
Mailing Address - Phone:516-302-6241
Mailing Address - Fax:516-586-5562
Practice Address - Street 1:910 ROUTE 109
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-1158
Practice Address - Country:US
Practice Address - Phone:631-957-5551
Practice Address - Fax:631-991-3345
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235264-1207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02833172Medicaid
NY02833172Medicaid
NYI50010Medicare UPIN