Provider Demographics
NPI:1639309347
Name:AHMADI, ESHWA B (MD)
Entity Type:Individual
Prefix:DR
First Name:ESHWA
Middle Name:B
Last Name:AHMADI
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 1:30 EUCLID AVE APT 4F
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-4568
Mailing Address - Country:US
Mailing Address - Phone:917-345-3370
Mailing Address - Fax:
Practice Address - Street 1:30 EUCLID AVE APT 4F
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-4568
Practice Address - Country:US
Practice Address - Phone:917-345-3370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-16
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA108070207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine