Provider Demographics
NPI:1295367654
Name:AHMED, ANOOSHA SAIYADAH (PA-C)
Entity type:Individual
Prefix:MS
First Name:ANOOSHA
Middle Name:SAIYADAH
Last Name:AHMED
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 BLACK GUM DR
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08852-1961
Mailing Address - Country:US
Mailing Address - Phone:201-888-4950
Mailing Address - Fax:
Practice Address - Street 1:16 BLACK GUM DR
Practice Address - Street 2:
Practice Address - City:MONMOUTH JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08852-1961
Practice Address - Country:US
Practice Address - Phone:201-888-4950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant