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General NPI Number Information
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NPI Number | 1265449334
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Entity Type | Individual
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Provider Name | ROSALINE A AHKAMI MD
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Gender | Female
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 122 MT BETHEL RD STE 1 WARREN DERMATOLOGY ASSOCIATES LLC
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City | WARREN
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State | NJ
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Zip | 07059
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Country | US
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Telephone | 908-756-7999
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Fax | 908-756-8017
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Provider Business Mailing Address
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Address Line | 55 CHURCHILL DR
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City | CLIFTON
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State | NJ
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Zip | 07103
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Country | US
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Telephone | 973-471-1989
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MA064016
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License Number State | NJ
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