Provider Demographics
NPI:1093763039
Name:BAGHAL, EYAD Y (MD)
Entity Type:Individual
Prefix:
First Name:EYAD
Middle Name:Y
Last Name:BAGHAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:EYAD
Other - Middle Name:Y
Other - Last Name:BAGHAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:160 HALEDON AVE
Mailing Address - Street 2:
Mailing Address - City:PROSPECT PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07508-2051
Mailing Address - Country:US
Mailing Address - Phone:973-782-4871
Mailing Address - Fax:973-782-4873
Practice Address - Street 1:160 HALEDON AVE
Practice Address - Street 2:
Practice Address - City:PROSPECT PARK
Practice Address - State:NJ
Practice Address - Zip Code:07508-2051
Practice Address - Country:US
Practice Address - Phone:973-782-4871
Practice Address - Fax:973-782-4873
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ62757207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ930085578OtherRAILROAD MEDICARE
NJ6826709Medicaid
NJ2369731OtherAETNA
NJP1917921OtherOXFORD
NJ1K6598OtherHEALTHNET
NJG21264Medicare UPIN
NJ6826709Medicaid