Provider Demographics
NPI:1407184435
Name:INTERNAL MEDICINE INSTITUTE OF NEW JERSEY, LLC
Entity Type:Organization
Organization Name:INTERNAL MEDICINE INSTITUTE OF NEW JERSEY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ABEER
Authorized Official - Middle Name:S
Authorized Official - Last Name:ELESSAWI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-455-8090
Mailing Address - Street 1:444 NEPTUNE BLVD
Mailing Address - Street 2:SUITE 13
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-4121
Mailing Address - Country:US
Mailing Address - Phone:732-455-8090
Mailing Address - Fax:732-455-8091
Practice Address - Street 1:444 NEPTUNE BLVD
Practice Address - Street 2:SUITE 13
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4121
Practice Address - Country:US
Practice Address - Phone:732-455-8090
Practice Address - Fax:732-455-8091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty