Provider Demographics
NPI:1023117736
Name:BEHZAD AHKAMI M.D
Entity type:Organization
Organization Name:BEHZAD AHKAMI M.D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:BEHZAD
Authorized Official - Middle Name:
Authorized Official - Last Name:AHKAMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-471-5444
Mailing Address - Street 1:930 CLIFTON AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2723
Mailing Address - Country:US
Mailing Address - Phone:973-471-5444
Mailing Address - Fax:973-778-0848
Practice Address - Street 1:930 CLIFTON AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2723
Practice Address - Country:US
Practice Address - Phone:973-471-5444
Practice Address - Fax:973-778-0848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04650600174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC56839Medicare UPIN
NJ521080Medicare PIN