Provider Demographics
NPI:1306011101
Name:ALHAMRAWY, ISMAIL A (MD)
Entity Type:Individual
Prefix:DR
First Name:ISMAIL
Middle Name:A
Last Name:ALHAMRAWY
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 1:1814 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-1751
Mailing Address - Country:US
Mailing Address - Phone:908-889-2168
Mailing Address - Fax:908-889-2179
Practice Address - Street 1:1814 EAST 2ND STREET
Practice Address - Street 2:
Practice Address - City:SCOTCH PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07076
Practice Address - Country:US
Practice Address - Phone:908-889-2168
Practice Address - Fax:908-889-2179
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08674400208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1407214661Medicare PIN