Provider Demographics
NPI:1649469321
Name:AHKAMI, BEHZAD (MD)
Entity type:Individual
Prefix:DR
First Name:BEHZAD
Middle Name:
Last Name:AHKAMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:BEHZAD
Other - Middle Name:
Other - Last Name:AHKAMI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:506 HAMBURG TPKE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2068
Mailing Address - Country:US
Mailing Address - Phone:973-471-5444
Mailing Address - Fax:973-778-0848
Practice Address - Street 1:506 HAMBURG TPKE
Practice Address - Street 2:SUITE 103
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2068
Practice Address - Country:US
Practice Address - Phone:973-471-5444
Practice Address - Fax:973-778-0848
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-18
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA046506002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ521080Medicare PIN