Individual
SHAMSUN AHMED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
139 ALBION AVE, PATERSON, NJ 07502-1913
(862) 262-2663
Mailing address
139 ALBION AVE, PATERSON, NJ 07502-1913
(862) 262-2663
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
106S00000X
Behavior Technician
—
—
374U00000X
Home Health Aide
Primary
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01092018
—
NJ
Enumeration date
07/08/2019
Last updated
07/08/2019
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