Provider Demographics
NPI:1467452565
Name:SAHLOUL, ELSAYED A (MD)
Entity Type:Individual
Prefix:
First Name:ELSAYED
Middle Name:A
Last Name:SAHLOUL
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 1:1 BETHANY RD
Mailing Address - Street 2:BLDG #2, STE #25
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1660
Mailing Address - Country:US
Mailing Address - Phone:732-217-3208
Mailing Address - Fax:732-217-3107
Practice Address - Street 1:1 BETHANY RD
Practice Address - Street 2:BLDG #2, STE #25
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1660
Practice Address - Country:US
Practice Address - Phone:732-217-3208
Practice Address - Fax:732-217-3107
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-29
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07118000207R00000X
NJ25MA071180207RI0008X
PAMD451598208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatologyGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0444740Medicaid
NJ8688206Medicaid
NJ8688206Medicaid