Imtiaz Ahmad, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

25MA03908600 Issued in NJ

Practice address

308 Willow Ave.
Hoboken, NJ 07030-3808

Phone

(201) 418-1420

Fax

(201) 418-1983

NPI assigned

Dec 5, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hoboken Pathology Associates PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Hoboken, NJ
  • NPI 1831250901
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235952000000",
    "number": "1720146384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4567 CROSSROADS PARK DRIVE",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883589",
            "telephone_number": "315-295-2100",
            "fax_number": "201-454-0136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 WILLOW AVE.",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070303808",
            "telephone_number": "201-418-1420",
            "fax_number": "201-418-1983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMAD",
        "first_name": "IMTIAZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2009-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NJ",
            "license": "25MA03908600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3626202",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Advanced Infectious Disease Medical, LLC
• Advanced Support Services LLC
• Sandra Marie Aguero, PHARMD
• Raul Francisco Aguilar, M.D.
• Nana Agyemang, RPH
• Alexander K Ahn
• Michael Ahn, DO
• Shadia M Ajaj, MD
• Latrice Akuamoah, M.D.
• Albini Pharmacy Inc

• Anatomic Pathology & Clinical Pathology Physician in Hoboken, NJ
• Providers in Hoboken, NJ by specialty
• Anatomic Pathology & Clinical Pathology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.