Provider Demographics
NPI:1528188604
Name:ELSAYED SAHLOUL MD PC
Entity Type:Organization
Organization Name:ELSAYED SAHLOUL MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELSAYED
Authorized Official - Middle Name:
Authorized Official - Last Name:SAHLOUL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-866-1143
Mailing Address - Street 1:500 78TH ST
Mailing Address - Street 2:2ND FL
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-4927
Mailing Address - Country:US
Mailing Address - Phone:201-868-9449
Mailing Address - Fax:201-868-7497
Practice Address - Street 1:500 78TH ST
Practice Address - Street 2:2ND FL
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-4927
Practice Address - Country:US
Practice Address - Phone:201-868-9449
Practice Address - Fax:201-868-7497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA071180207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ111512Medicare PIN
NJH51084Medicare UPIN