Provider Demographics
NPI:1306101316
Name:AHMED, SYED TAWFIQ
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:TAWFIQ
Last Name:AHMED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:SYED
Other - Middle Name:TAWFIQ
Other - Last Name:AHMED
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTA/L
Mailing Address - Street 1:1218 NEPTUNE AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-2903
Mailing Address - Country:US
Mailing Address - Phone:718-676-2191
Mailing Address - Fax:
Practice Address - Street 1:1218 NEPTUNE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-2903
Practice Address - Country:US
Practice Address - Phone:718-676-2191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-06
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004161224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant