Provider Demographics
NPI:1114955895
Name:ELRAFEI, MOHAMED A (MD)
Entity Type:Individual
Prefix:MR
First Name:MOHAMED
Middle Name:A
Last Name:ELRAFEI
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 1:794 PEACH TREE LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-2333
Mailing Address - Country:US
Mailing Address - Phone:973-790-9222
Mailing Address - Fax:973-790-0671
Practice Address - Street 1:401 HAMBURG TPKE
Practice Address - Street 2:SUIT 303
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2154
Practice Address - Country:US
Practice Address - Phone:973-790-9222
Practice Address - Fax:973-790-0871
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0508572084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE54572Medicare UPIN
NJ623972Medicare ID - Type UnspecifiedMEDICARE NUMBER