Provider Demographics
NPI:1437240298
Name:ELKHOLY, WAEL (MD, LAC)
Entity Type:Individual
Prefix:
First Name:WAEL
Middle Name:
Last Name:ELKHOLY
Suffix:
Gender:M
Credentials:MD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 GRAYSON DR
Mailing Address - Street 2:
Mailing Address - City:BELLE MEAD
Mailing Address - State:NJ
Mailing Address - Zip Code:08502-4932
Mailing Address - Country:US
Mailing Address - Phone:732-762-6143
Mailing Address - Fax:
Practice Address - Street 1:1255 WHITEHORSE MERCERVILLE RD STE 510
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3800
Practice Address - Country:US
Practice Address - Phone:732-444-8888
Practice Address - Fax:732-515-4000
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ000736171100000X
NJ25MA07057900207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No171100000XOther Service ProvidersAcupuncturist
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP01033195OtherRR MEDICARE
NJ8237603Medicaid
NJP01033195OtherRR MEDICARE
NJG37262Medicare UPIN
NJ039356A01Medicare PIN