Individual
AHMED A MOHAMMED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
724 23RD ST # 2, WATERVLIET, NY 12189-2036
(518) 818-9143
Mailing address
724 23RD ST # 2, WATERVLIET, NY 12189-2036
(518) 818-9143
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05808806
—
NY
Enumeration date
05/26/2020
Last updated
05/26/2020
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