Tangoren, Ibrahim Ahmad

Tangoren, Ibrahim Ahmad is an sole proprietor health care provider with primary practice located at 2949 Erie Boulevard East , Syracuse NY 13224-1460. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Tangoren, Ibrahim Ahmad can be contacted via phone (315) 579-9037.

Contact Information

Primary practice address
2949 Erie Boulevard East Syracuse NY 13224-1460
Phone: (315) 579-9037
Fax: (315) 424-1779
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 209386 New York

Profile Details

NPI number 1770578601
LBN Legal business name Tangoren, Ibrahim Ahmad
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 16th, 2005
Last updated Oct 25th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770578601 NPPES
New York MEDICAID 01899210

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