Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Samuel Jack Ahmad, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1073216149

Samuel Jack Ahmad, MD is a Student in an Organized Health Care Education/Training Program in Staten Island, New York. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

475 Seaview Ave
Staten Island, NY 10305-3436
Phone: (718) 226-8313
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1073216149
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 27, 2023
Last updated in NPPESMarch 27, 2023
Certification dateMarch 25, 2023
Mailing address475 Seaview Ave, Staten Island, NY 10305-3436

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