Healthcare Provider Details

I. General information

NPI: 1104898311
Provider Name (Legal Business Name): JAWAD AHMAD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 05/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 E 98TH ST BOX 1104
NEW YORK NY
10029-6501
US

IV. Provider business mailing address

1 GUSTAVE L.LEVY PLACE BOX 1104
NEW YORK NY
10029
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-0034
  • Fax: 212-289-7738
Mailing address:
  • Phone: 212-987-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number253593
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License Number253593
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number253593
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: