Provider Demographics
NPI:1700022043
Name:AHMED, IRFAN HAROON (MD)
Entity Type:Individual
Prefix:DR
First Name:IRFAN
Middle Name:HAROON
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 1:140 BERGEN ST # D1610
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103-2425
Mailing Address - Country:US
Mailing Address - Phone:973-972-0763
Mailing Address - Fax:
Practice Address - Street 1:140 BERGEN ST # D1610
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2425
Practice Address - Country:US
Practice Address - Phone:973-972-0763
Practice Address - Fax:973-972-3897
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-16
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT185337207X00000X
MA249143207X00000X
NJ25MA09198900207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery