Physician Compare National (NPI:1285735860)

HEALTHCARE PROVIDER: MIR M AHMAD M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1285735860
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1658496997
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100910000135
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	AHMAD
	Individual professional last name
Provider First Name	MIR
	Individual professional first name
Provider Middle Name	MAQBOOL
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1995
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	NEPHROLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	NEPHROLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	580 FRELINGHUYSEN AVE
	Group Practice or individual's line 1 address
City	NEWARK
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	071141361
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	310039
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	RARITAN BAY MEDICAL CENTER PERTH AMBOY DIVISION
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y