Iqbal Ahmad, MD LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

26455 Issued in NJ

Legal business name

IQBAL AHMAD, MD LLC

Practice address

45 Academy St
Suite 203
Newark, NJ 07102-2924

Phone

(973) 643-5900

Fax

(973) 643-3171

NPI assigned

Oct 3, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Joann Pagan

Title

Office Manager

Phone

(973) 643-5900

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218153600000",
    "number": "1891982880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 ACADEMY ST",
            "address_2": "SUITE 203",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071022924",
            "telephone_number": "973-643-5900",
            "fax_number": "973-643-3171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 ACADEMY ST",
            "address_2": "SUITE 203",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071022924",
            "telephone_number": "973-643-5900",
            "fax_number": "973-643-3171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IQBAL AHMAD, MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-03",
        "last_updated": "2008-08-08",
        "status": "A",
        "authorized_official_last_name": "PAGAN",
        "authorized_official_first_name": "JOANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "973-643-5900",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "26455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4979401",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "108356",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "1100092",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "MI000012001",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Newark, NJ
• Providers in Newark, NJ by specialty
• Specialist in New Jersey

• 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.

Verify at the official NPI Registry.