# AHAMED S MOIDEEN MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164616116
- **Authorized official:** AHAMED S MOIDEEN MD FACS FCCP RPVI (PRESIDENT)
- **Authorized official phone:** (718) 359-8346

## Contact information

- **Practice address:** 142 04 BAYSIDE AVE, STE 5L, FLUSHING, NY 11354-2331
- **Practice address phone:** (718) 359-8346
- **Practice address fax:** (718) 359-8342
- **Mailing address:** 142 04 BAYSIDE AVE, STE 5L, FLUSHING., NY 11354-2331
- **Mailing address phone:** (718) 359-8346
- **Mailing address fax:** (718) 359-8342

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | 132106 | NY | — |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 132106 | NY | Yes |

## Other

- **Enumeration date:** 09/04/2007
- **Last updated:** 09/28/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00612253 | — | NY |