Provider Demographics
NPI:1992768170
Name:AHMAD, MIAN NIAZ (MD)
Entity type:Individual
Prefix:DR
First Name:MIAN
Middle Name:NIAZ
Last Name:AHMAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 CLUBHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13903-1208
Mailing Address - Country:US
Mailing Address - Phone:607-724-8797
Mailing Address - Fax:
Practice Address - Street 1:425 ROBINSON ST
Practice Address - Street 2:BINGHAMTON VETERANS CLINIC
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13901-4101
Practice Address - Country:US
Practice Address - Phone:607-772-9100
Practice Address - Fax:607-772-3081
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2007-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY117267207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine