Provider Demographics
NPI:1225023682
Name:AHMED, ASMA TALUKDER (DO)
Entity Type:Individual
Prefix:DR
First Name:ASMA
Middle Name:TALUKDER
Last Name:AHMED
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:ASMA
Other - Middle Name:WASIM
Other - Last Name:TALUKDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:30 WILDERNESS DR
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-3416
Mailing Address - Country:US
Mailing Address - Phone:856-435-0515
Mailing Address - Fax:
Practice Address - Street 1:30 WILDERNESS DR
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-3416
Practice Address - Country:US
Practice Address - Phone:856-435-0515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07790500207R00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0055352Medicaid
NJ457111MK3Medicare PIN
NJ457111CLDMedicare PIN
NJH93705Medicare UPIN
NJ0055352Medicaid
NJ457111BE0Medicare PIN
NJ088014Medicare ID - Type Unspecified