Individual
DAVID FARD AHMADI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
222 EASTON AVE, SUITE C, NEW BRUNSWICK, NJ 08901-1723
(732) 828-6404
(732) 846-8035
Mailing address
222 EASTON AVE, SUITE C, NEW BRUNSWICK, NJ 08901-1723
(732) 828-6404
(732) 846-8035
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
25MA03724500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MA03724500
MEDICAL LICENSE
NJ
Enumeration date
08/10/2005
Last updated
06/20/2013
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