Provider Demographics
NPI:1578661682
Name:AHMED, WASIF MOHIUDDIN (MD,)
Entity Type:Individual
Prefix:DR
First Name:WASIF
Middle Name:MOHIUDDIN
Last Name:AHMED
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 1:13 THRUSH CT
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-3501
Mailing Address - Country:US
Mailing Address - Phone:732-952-3038
Mailing Address - Fax:732-952-3038
Practice Address - Street 1:760 BROADWAY
Practice Address - Street 2:DEPT. OF ANESTHESIA
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-5317
Practice Address - Country:US
Practice Address - Phone:718-963-8496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236135207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology