MEDICARE: DR. AQEEL AHMED 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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	250285	NY
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	25MA08469800	NJ

General Provider Information

NPI Number	:	1538300991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AQEEL AHMED M.D.

Provider Business Mailing Address
First Line	:	240 W FIRST ST
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08820-1222
Country	:	US
Telephone Number	:	732-362-1972
Fax Number	:

Provider Business Practice Location Address
First Line	:	1130 SAINT NICHOLAS AVE
Second Line	:	R-301
City	:	NEW YORK
State	:	NY
Zip	:	10032-3802
Country	:	US
Telephone Number	:	212-851-4505
Fax Number	:

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

Provider Enumeration Date	:	03/16/2009
Last Update Date	:	03/16/2009

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