Provider Demographics
NPI:1790203222
Name:AHMED, NADINE ZARA (OD)
Entity Type:Individual
Prefix:
First Name:NADINE
Middle Name:ZARA
Last Name:AHMED
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 CHRISTOPHER COLUMBUS DR APT 2802
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-5714
Mailing Address - Country:US
Mailing Address - Phone:859-494-8820
Mailing Address - Fax:
Practice Address - Street 1:368 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-2828
Practice Address - Country:US
Practice Address - Phone:201-659-2774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-05
Last Update Date:2019-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00689800152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist