Provider Demographics
NPI:1801392253
Name:AKHTAR, AMAD (DPT)
Entity Type:Individual
Prefix:DR
First Name:AMAD
Middle Name:
Last Name:AKHTAR
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 NAUTILUS DR STE 1
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-2466
Mailing Address - Country:US
Mailing Address - Phone:609-978-1001
Mailing Address - Fax:609-978-0914
Practice Address - Street 1:44 NAUTILUS DR STE 1
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2466
Practice Address - Country:US
Practice Address - Phone:609-978-1001
Practice Address - Fax:609-978-0914
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01768800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist