Provider Demographics
NPI:1831112440
Name:AHMED, JAMAL J (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMAL
Middle Name:J
Last Name:AHMED
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6700 KIRKVILLED RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057
Mailing Address - Country:US
Mailing Address - Phone:315-277-2707
Mailing Address - Fax:315-505-1665
Practice Address - Street 1:6700 KIRKVILLED RD
Practice Address - Street 2:STE 203
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9313
Practice Address - Country:US
Practice Address - Phone:315-277-2707
Practice Address - Fax:315-505-1665
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2020-03-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY255144207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02838613Medicaid
P00466914Medicare PIN
RB4455Medicare PIN
RB7509Medicare PIN
RB3054Medicare UPIN