Provider Demographics
NPI:1669412946
Name:AHMAD, NAVEED (MD)
Entity type:Individual
Prefix:
First Name:NAVEED
Middle Name:
Last Name:AHMAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 SUYDAM RD
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-7305
Mailing Address - Country:US
Mailing Address - Phone:732-951-9401
Mailing Address - Fax:732-951-9402
Practice Address - Street 1:5210 CHURCH AVE
Practice Address - Street 2:#1 R
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-3554
Practice Address - Country:US
Practice Address - Phone:718-498-1028
Practice Address - Fax:732-951-9402
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY153076207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00851872Medicaid
NYB12704Medicare UPIN
NY31D011Medicare PIN