Mohamed Ahmed

Individual provider Active NPI Behavior Technician · Randolph, MA

NPI 1124895255 · NPPES record last updated Dec 8, 2023

Key facts

NPI
1124895255
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
41 Pacella Park Dr
Randolph, MA 02368-1755
Phone
(781) 440-0400
NPI assigned
Dec 8, 2023
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

41 Pacella Park Dr
Randolph, MA 02368-1755

Mailing address

41 Pacella Park Dr
Randolph, MA 02368-1755
Phone (781) 440-0400

Other identifiers

IdentifierTypeStateIssuer
110026265EMedicaidMA

Other providers in Randolph, MA

All providers in Randolph, MA · Behavior Technician in Massachusetts

Sources for this page

Verify at the official NPI Registry.