Provider Demographics
NPI:1265877385
Name:AHMED, SYED MATEEN (DO)
Entity type:Individual
Prefix:DR
First Name:SYED
Middle Name:MATEEN
Last Name:AHMED
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 STATION DR APT 221
Mailing Address - Street 2:
Mailing Address - City:AVENEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07001-1793
Mailing Address - Country:US
Mailing Address - Phone:914-262-0199
Mailing Address - Fax:
Practice Address - Street 1:103 RIVER RD STE 101
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-1016
Practice Address - Country:US
Practice Address - Phone:914-262-0199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-02
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY288437-1208100000X
NJ25MB10077900208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation