Provider Demographics
NPI:1902913783
Name:AHMED, NASRINE (DDS)
Entity Type:Individual
Prefix:DR
First Name:NASRINE
Middle Name:
Last Name:AHMED
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4470 BROADWAY
Mailing Address - Street 2:SUITE 4
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-2669
Mailing Address - Country:US
Mailing Address - Phone:212-569-7144
Mailing Address - Fax:646-224-1320
Practice Address - Street 1:4470 BROADWAY
Practice Address - Street 2:SUITE 4
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-2669
Practice Address - Country:US
Practice Address - Phone:212-569-7144
Practice Address - Fax:646-224-1320
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ222271223G0001X
NY050704122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist