Healthcare Provider Details

I. General information

NPI: 1417203787
Provider Name (Legal Business Name): AHMED HAMDI ALANSARI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2012
Last Update Date: 08/18/2020
Certification Date: 08/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 COUNTY ROAD 520
MARLBORO NJ
07746-1059
US

IV. Provider business mailing address

187 ROUTE 36 STE 230
WEST LONG BRANCH NJ
07764-1306
US

V. Phone/Fax

Practice location:
  • Phone: 732-370-2220
  • Fax:
Mailing address:
  • Phone: 732-222-3805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number25MA10764000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: