MEDICARE: DR. PARVEZ MAHMOOD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	25MA02823000	NJ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	534044BD9	OTHER	NJ	MEDICARE ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	222843719	OTHER	NJ	TAX ID
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	31D0715825	OTHER	NJ	CLIA

General Provider Information

NPI Number	:	1174520936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PARVEZ MAHMOOD M.D.

Provider Business Mailing Address
First Line	:	20 HOSPITAL DR
Second Line	:	SUITE 15
City	:	TOMS RIVER
State	:	NJ
Zip	:	08755-6434
Country	:	US
Telephone Number	:	732-286-6644
Fax Number	:	732-286-9321

Provider Business Practice Location Address
First Line	:	20 HOSPITAL DR
Second Line	:	SUITE 15
City	:	TOMS RIVER
State	:	NJ
Zip	:	08755-6434
Country	:	US
Telephone Number	:	732-286-6644
Fax Number	:	732-286-9321

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	09/20/2007

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Directions to “ DR. PARVEZ MAHMOOD M.D.” Practice Location

Language	Start Address	Practice Location

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