Provider Demographics
NPI:1104104769
Name:AHMAD MASOOD M.D., P.C.
Entity type:Organization
Organization Name:AHMAD MASOOD M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MASOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PC
Authorized Official - Phone:845-569-8600
Mailing Address - Street 1:815 BLOOMING GROVE TPKE
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-8135
Mailing Address - Country:US
Mailing Address - Phone:845-569-8600
Mailing Address - Fax:845-569-8788
Practice Address - Street 1:815 BLOOMING GROVE TPKE
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-8135
Practice Address - Country:US
Practice Address - Phone:845-569-8600
Practice Address - Fax:845-569-8788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
28U902Medicare PIN