Healthcare Provider Details

I. General information

NPI: 1760007652
Provider Name (Legal Business Name): ABDULLAH SULTAN AHMAD AHMAD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2020
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 ENGLE ST
ENGLEWOOD NJ
07631-1808
US

IV. Provider business mailing address

350 ENGLE ST
ENGLEWOOD NJ
07631-1808
US

V. Phone/Fax

Practice location:
  • Phone: 201-894-3143
  • Fax:
Mailing address:
  • Phone: 201-894-3143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1026249
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number1026249
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: