Healthcare Provider Details

I. General information

NPI: 1841266780
Provider Name (Legal Business Name): NASIM AHMED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 STATE ROUTE 33
NEPTUNE NJ
07753-4859
US

IV. Provider business mailing address

1919 FIDDLERS RUN
TOMS RIVER NJ
08755-1454
US

V. Phone/Fax

Practice location:
  • Phone: 732-776-4949
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberMA72349
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: