Provider Demographics
NPI:1629162177
Name:AHMAD, SYED S (MD)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:S
Last Name:AHMAD
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 1:183 FRANKLIN CORNER ROAD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2555
Mailing Address - Country:US
Mailing Address - Phone:609-896-0622
Mailing Address - Fax:609-896-0069
Practice Address - Street 1:183 FRANKLIN CORNER ROAD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2555
Practice Address - Country:US
Practice Address - Phone:609-896-0622
Practice Address - Fax:609-896-0069
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA35635207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1534203Medicaid
NJ093645Medicare ID - Type Unspecified
NJ1534203Medicaid