Healthcare Provider Details

I. General information

NPI: 1831717826
Provider Name (Legal Business Name): USMAN AHMED
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2020
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 NEW BRUNSWICK AVE
PERTH AMBOY NJ
08861-3654
US

IV. Provider business mailing address

14 AMAGANSETT LN
MATAWAN NJ
07747-6851
US

V. Phone/Fax

Practice location:
  • Phone: 732-442-3700
  • Fax:
Mailing address:
  • Phone: 718-864-9358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MB12056500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: