1376912550 NPI number — SYED MUHAMMAD AHSAN MEHDI M.D

Table of content: SYED MUHAMMAD AHSAN MEHDI M.D (NPI 1376912550)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376912550 NPI number — SYED MUHAMMAD AHSAN MEHDI M.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEHDI
Provider First Name:
SYED MUHAMMAD AHSAN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376912550
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/12/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1051 RIVERSIDE DRIVE UNIT 103/ROOM 101B
Provider Second Line Business Mailing Address:
COLUMBIA UNIVERSITY/NEW YORK STATE PSYCHIATRIC INST.
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10032
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
467-747-5056
Provider Business Mailing Address Fax Number:
646-774-6398

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
425 ROBINSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BINGHAMTON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13904-1735
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
607-773-4061
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/17/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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