Healthcare Provider Details

I. General information

NPI: 1083120570
Provider Name (Legal Business Name): AH MEDICAL PC DBA CLIFTON MEDICAL AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2017
Last Update Date: 06/21/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 BROAD ST STE 1D
CLIFTON NJ
07013-1645
US

IV. Provider business mailing address

716 BROAD ST STE 1D
CLIFTON NJ
07013-1645
US

V. Phone/Fax

Practice location:
  • Phone: 973-333-0404
  • Fax: 973-333-0505
Mailing address:
  • Phone: 973-333-0404
  • Fax: 973-333-0505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number25MA09814600
License Number StateNJ

VIII. Authorized Official

Name: OMAR F AHMED
Title or Position: MD
Credential: MD
Phone: 917-574-5334