Provider Demographics
NPI:1073043790
Name:AHMED, ROZINA A
Entity type:Individual
Prefix:
First Name:ROZINA
Middle Name:A
Last Name:AHMED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 S PERSHING AVE
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-4344
Mailing Address - Country:US
Mailing Address - Phone:1516-513-1518
Mailing Address - Fax:
Practice Address - Street 1:226 S PERSHING AVE
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-4344
Practice Address - Country:US
Practice Address - Phone:1516-513-1518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2017-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician