Provider Demographics
NPI:1669552881
Name:AHMAD, ARLENE (MD)
Entity type:Individual
Prefix:DR
First Name:ARLENE
Middle Name:
Last Name:AHMAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BOONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07005
Mailing Address - Country:US
Mailing Address - Phone:973-263-2080
Mailing Address - Fax:973-263-3727
Practice Address - Street 1:223 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BOONTON
Practice Address - State:NJ
Practice Address - Zip Code:07005
Practice Address - Country:US
Practice Address - Phone:973-263-2080
Practice Address - Fax:973-263-3727
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03113100207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2223994880OtherHORIZON
4235040OtherAETNA
080153969OtherRAILROAD MEDICARE
4235040OtherAETNA
D06705Medicare UPIN