Active NPI
Ahmad Farzad, MD
- Otolaryngology Physician
- Pennington, NJ
National Provider Identifier
1578591533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 036094637
- Practice address
- 2480 Pennington Rd
Suite 105
Pennington, NJ 08534 - Phone
- (609) 737-7555
- Fax
- (609) 737-7032
- NPI assigned
- Jun 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 036094637 | IL | Primary |
Addresses
Primary practice location
2480 Pennington Rd
Suite 105
Pennington, NJ 08534
Mailing address
2480 Pennington Rd
Suite 105
Pennington, NJ 08534
Phone (609) 737-7555
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34560 | Other | NJ | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036094637 | IL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218153600000",
"number": "1578591533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2480 PENNINGTON RD",
"address_2": "SUITE 105",
"city": "PENNINGTON",
"state": "NJ",
"postal_code": "08534",
"telephone_number": "609-737-7555",
"fax_number": "609-737-7032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2480 PENNINGTON RD",
"address_2": "SUITE 105",
"city": "PENNINGTON",
"state": "NJ",
"postal_code": "08534",
"telephone_number": "609-737-7555",
"fax_number": "609-737-7032"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARZAD",
"first_name": "AHMAD",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-29",
"last_updated": "2008-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "IL",
"license": "036094637",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "34560",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pennington, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.