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General NPI Number Information
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NPI Number | 1730074147
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Entity Type | Individual
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Provider Name | HATEM AHMED
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Gender | Male
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 217 GETTY AVENUE UNIT 1F
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City | PATERSON
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State | NJ
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Zip | 07503
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Country | US
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Telephone | 646-683-0594
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Fax |
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Provider Business Mailing Address
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Address Line | 252 N 10TH ST FL 1
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City | PROSPECT PARK
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State | NJ
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Zip | 07508-2008
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Country | US
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Telephone | 646-683-0594
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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 | 171W00000X
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Taxonomy Name | Contractor
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License Number | 872783395000
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License Number State | NJ
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