Provider Demographics
NPI:1518582766
Name:NASHAT, AHMED
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:NASHAT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:AHMED
Other - Middle Name:
Other - Last Name:AHMED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1 E. NEW YORK AVE
Mailing Address - Street 2:4TH FLOOR ADMIN
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244
Mailing Address - Country:US
Mailing Address - Phone:609-653-3265
Mailing Address - Fax:
Practice Address - Street 1:401 BETHEL RD
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2108
Practice Address - Country:US
Practice Address - Phone:609-356-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-13
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT220687207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ71199981Medicaid