Provider Demographics
NPI:1194481317
Name:AHMED, KOBIR
Entity type:Individual
Prefix:MR
First Name:KOBIR
Middle Name:
Last Name:AHMED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 WAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07502-4100
Mailing Address - Country:US
Mailing Address - Phone:973-998-6992
Mailing Address - Fax:973-998-6993
Practice Address - Street 1:128 WAYNE AVE
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07502-4100
Practice Address - Country:US
Practice Address - Phone:973-998-6992
Practice Address - Fax:973-998-6993
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide