Provider Demographics
NPI:1730491812
Name:AHMAD KAZEMI MD PA
Entity Type:Organization
Organization Name:AHMAD KAZEMI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:KAZEMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-272-1300
Mailing Address - Street 1:562 BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:KENILWORTH
Mailing Address - State:NJ
Mailing Address - Zip Code:07033
Mailing Address - Country:US
Mailing Address - Phone:908-272-1300
Mailing Address - Fax:908-272-3231
Practice Address - Street 1:562 BOULEVARD
Practice Address - Street 2:
Practice Address - City:KENILWORTH
Practice Address - State:NJ
Practice Address - Zip Code:07033
Practice Address - Country:US
Practice Address - Phone:908-272-1300
Practice Address - Fax:908-272-3231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-06
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty