Provider Demographics
NPI:1396906913
Name:MAHMOOD, NADER AHMAD (MD)
Entity type:Individual
Prefix:
First Name:NADER
Middle Name:AHMAD
Last Name:MAHMOOD
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 1:127 UNION ST STE 105
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-4436
Mailing Address - Country:US
Mailing Address - Phone:973-321-1670
Mailing Address - Fax:973-321-1672
Practice Address - Street 1:127 UNION ST STE 105
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-4436
Practice Address - Country:US
Practice Address - Phone:973-321-1670
Practice Address - Fax:973-321-1672
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2024-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08909100207R00000X, 207RP1001X
NY284261-1207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine