Provider Demographics
NPI:1033181680
Name:MEKKAWY, AHMED ABDEL (MD)
Entity Type:Individual
Prefix:DR
First Name:AHMED
Middle Name:ABDEL
Last Name:MEKKAWY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 CLIFTON AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2724
Mailing Address - Country:US
Mailing Address - Phone:973-778-5070
Mailing Address - Fax:973-778-2878
Practice Address - Street 1:925 CLIFTON AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2724
Practice Address - Country:US
Practice Address - Phone:973-778-5070
Practice Address - Fax:973-778-2878
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA43016207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1884301Medicaid
NJ1884301Medicaid
NJ585308Medicare ID - Type Unspecified