Provider Demographics
NPI:1689826471
Name:ZIAUDDIN AHMED, M.D., F.R.C.S., P.A.
Entity Type:Organization
Organization Name:ZIAUDDIN AHMED, M.D., F.R.C.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZIAUDDIN
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-791-8080
Mailing Address - Street 1:20-01 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-1523
Mailing Address - Country:US
Mailing Address - Phone:201-791-8080
Mailing Address - Fax:201-791-2202
Practice Address - Street 1:20-01 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-1523
Practice Address - Country:US
Practice Address - Phone:201-791-8080
Practice Address - Fax:201-791-2202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-13
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03469100207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ178356Medicare PIN