Provider Demographics
NPI:1003372715
Name:AHMED, ADIL (DO)
Entity type:Individual
Prefix:
First Name:ADIL
Middle Name:
Last Name:AHMED
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:420 MOUNTAIN AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:NEW PROVIDENCE
Mailing Address - State:NJ
Mailing Address - Zip Code:07974-2736
Mailing Address - Country:US
Mailing Address - Phone:732-920-3800
Mailing Address - Fax:732-920-5351
Practice Address - Street 1:515 BRICK BLVD
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-6009
Practice Address - Country:US
Practice Address - Phone:732-920-3800
Practice Address - Fax:732-920-5351
Is Sole Proprietor?:No
Enumeration Date:2019-02-18
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20737207W00000X
NJ25MA12233100207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology