Provider Demographics
NPI:1306533609
Name:ISMAIL, AMMAR AHMED KADRI ABDALLA (MD)
Entity type:Individual
Prefix:
First Name:AMMAR
Middle Name:AHMED KADRI ABDALLA
Last Name:ISMAIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 E 19TH ST, APT 522
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002
Mailing Address - Country:US
Mailing Address - Phone:216-418-2945
Mailing Address - Fax:
Practice Address - Street 1:355 GRAND STREET
Practice Address - Street 2:DEPARTMENT OF MEDICINE 1 EAST
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302
Practice Address - Country:US
Practice Address - Phone:201-915-2000
Practice Address - Fax:201-915-2219
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2025-02-24
Deactivation Date:2023-11-22
Deactivation Code:
Reactivation Date:2025-02-24
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program