1427064617 NPI number — SARFARAZ AHMAD MD

Table of content: SARFARAZ AHMAD MD (NPI 1427064617)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427064617 NPI number — SARFARAZ AHMAD MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AHMAD
Provider First Name:
SARFARAZ
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427064617
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/09/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2651
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAMILTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08690-0151
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-213-1630
Provider Business Mailing Address Fax Number:
215-579-1632

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 HAMILTON HEALTH PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMILTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08690-3542
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-213-1630
Provider Business Practice Location Address Fax Number:
215-579-1632
Provider Enumeration Date:
07/31/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  25MA02557100 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1134161 . This is a "HORIZON MERCY" identifier . This identifiers is of the category "OTHER".
  • Identifier: P2358694 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2813301 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4058906 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".