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Organization
MOINUDDIN AHMED
Active
Organization
MOINUDDIN AHMED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY LANDERS (OFFICE MGR)
(845) 856-2244
Entity
Organization
Contact information
Practice address
123 PIKE ST, SUITE 207, PORT JERVIS, NY 12771-1824
(845) 856-2244
(845) 856-1166
Mailing address
123 PIKE ST, SUITE 207, PORT JERVIS, NY 12771-1824
(845) 856-2244
(845) 856-1166
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
60211958
NY
207RP1001X
Pulmonary Disease Physician
60211958
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02062875
—
NY
Enumeration date
09/06/2005
Last updated
09/11/2025
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