Provider Demographics
NPI:1467544353
Name:MELEIS MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:MELEIS MEDICAL ASSOCIATES
Other - Org Name:MELEIS & KHALIL MEDICAL SERVICES LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:MELEIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-335-0900
Mailing Address - Street 1:233 MIDDLE RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1957
Mailing Address - Country:US
Mailing Address - Phone:732-335-0900
Mailing Address - Fax:732-335-8080
Practice Address - Street 1:233 MIDDLE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1957
Practice Address - Country:US
Practice Address - Phone:732-335-0900
Practice Address - Fax:732-335-8080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA56738207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8201307Medicaid
NJX48005Medicare UPIN
NJ035919Medicare ID - Type UnspecifiedGROUP NUMBER