Individual
IMRAN MAHMOOD AHMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3472 BROADWAY, NEW YORK, NY 10031-5630
(212) 694-1553
Mailing address
3472 BROADWAY, NEW YORK, NY 10031-5630
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
050477
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02376052
—
NY
Enumeration date
10/24/2007
Last updated
10/24/2007
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