Provider Demographics
NPI:1962464495
Name:AHMAD, TANVEER (MD)
Entity Type:Individual
Prefix:DR
First Name:TANVEER
Middle Name:
Last Name:AHMAD
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 1:1255 ROUTE 70 STE 23S
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5900
Mailing Address - Country:US
Mailing Address - Phone:732-534-0736
Mailing Address - Fax:732-534-0737
Practice Address - Street 1:1255 ROUTE 70 STE 23S
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5900
Practice Address - Country:US
Practice Address - Phone:732-534-0736
Practice Address - Fax:732-534-0737
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA051086174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
044362CW2Medicare ID - Type Unspecified
F33147Medicare UPIN