Provider Demographics
NPI:1376964023
Name:GOBRAN, EMAD NABIL (MD)
Entity Type:Individual
Prefix:
First Name:EMAD
Middle Name:NABIL
Last Name:GOBRAN
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 1:5 PLUM LN
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1018
Mailing Address - Country:US
Mailing Address - Phone:201-888-7355
Mailing Address - Fax:888-225-7355
Practice Address - Street 1:20 HOSPITAL DR STE 18
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6434
Practice Address - Country:US
Practice Address - Phone:732-569-6166
Practice Address - Fax:888-225-3365
Is Sole Proprietor?:No
Enumeration Date:2013-12-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10033500207RN0300X
NY272829207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJFG5097705OtherDEA
NYFG5097705OtherDEA
NY04087014Medicaid