Individual
IMTIAZ AHMED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 2ND AVE, LONG BRANCH, NJ 07740-6303
(610) 400-5782
Mailing address
400 SAIRS AVE, LONG BRANCH, NJ 07740-5683
(610) 400-5782
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD461387
PA
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
0442734
KS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/26/2014
Last updated
02/26/2020
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