Healthcare Provider Details

I. General information

NPI: 1144813601
Provider Name (Legal Business Name): AHMED AHMED
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2021
Last Update Date: 02/16/2021
Certification Date: 02/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

383 WASHINGTON AVENUE
HILLSDALE NJ
07642
US

IV. Provider business mailing address

334 E 100TH ST APT 6D
NEW YORK NY
10029-6630
US

V. Phone/Fax

Practice location:
  • Phone: 201-664-4250
  • Fax:
Mailing address:
  • Phone: 347-421-5140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI04125400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: