Provider Demographics
NPI:1639244833
Name:AHMED, AISHA IBRAHIM (MD)
Entity Type:Individual
Prefix:
First Name:AISHA
Middle Name:IBRAHIM
Last Name:AHMED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 WASHBURNE AVE
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08009-9621
Mailing Address - Country:US
Mailing Address - Phone:609-567-2659
Mailing Address - Fax:609-567-9054
Practice Address - Street 1:301 SPRING GARDEN RD
Practice Address - Street 2:ANCORA PSYCHIATRIC HOSPITAL
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-2516
Practice Address - Country:US
Practice Address - Phone:609-561-1700
Practice Address - Fax:609-561-2509
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA467562084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1639244833OtherNPI
F21667Medicare UPIN