Provider Demographics
NPI:1609952480
Name:MOHAMED H. ELNAHAL, P.A.
Entity Type:Organization
Organization Name:MOHAMED H. ELNAHAL, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:H
Authorized Official - Last Name:ELNAHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-652-5556
Mailing Address - Street 1:333 E JIMMIE LEEDS RD
Mailing Address - Street 2:EAST BUILDING SUITE 5
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-4123
Mailing Address - Country:US
Mailing Address - Phone:609-652-5556
Mailing Address - Fax:609-652-3330
Practice Address - Street 1:333 E JIMMIE LEEDS RD
Practice Address - Street 2:EAST BUILDING SUITE 5
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-4123
Practice Address - Country:US
Practice Address - Phone:609-652-5556
Practice Address - Fax:609-652-3330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05177500207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5101409Medicaid
2315845000OtherAMERIHEALTH HMO/POS/PC/PP
F14343OtherHEALTHNET
OXFORDOtherP400760
2OU29OtherEMPIRE BLUE CROSS
475541OtherAETNA PPO/POS/HMO
3617274005OtherCIGNA HMO/POS
=========OtherUNITED HEALTHCARE
2315845000OtherAMERIHEALTH HMO/POS/PC/PP
=========OtherAMERIHEALTH ADMINISTRATOR
=========OtherHORIZON BCBS
=========OtherCIGNA
OXFORDOtherP400760
=========OtherUNITED HEALTHCARE
=========OtherAMERIHEALTH ADMINISTRATOR