| Ahmad Javid, | |
|
24 Groton Ave, Cortland, NY 13045-2014 | |
| (607) 753-3774 | |
| (607) 753-3947 |
| Full Name | Ahmad Javid |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 24 Groton Ave, Cortland, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205832151 | NPI | - | NPPES |
| 01669089 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 5166489 (New York) | Primary |
| Entity Name | Adfinitas Health At Fauquier Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225558109 PECOS PAC ID: 1557627494 Enrollment ID: O20171109002793 |
| Entity Name | Southeastern Intensivist Services Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912942665 PECOS PAC ID: 9335152107 Enrollment ID: O20190131001122 |
| Mailing Address | Practice Location Address |
|---|---|
| Ahmad Javid, 85 South West Street, Homer, NY 13077 Ph: (607) 753-3797 | Ahmad Javid, 24 Groton Ave, Cortland, NY 13045-2014 Ph: (607) 753-3774 |
Dr. Amy Y Difabio, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 24 Groton Ave, Cortland, NY 13045 Phone: 607-753-3774 | |
Cathy Zarzecki, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 4038 West Rd, Cortland, NY 13045 Phone: 607-758-3008 Fax: 607-758-3019 |