Provider Demographics
NPI:1629189519
Name:DR MILIA &MAGDY GHALY MD PA
Entity Type:Organization
Organization Name:DR MILIA &MAGDY GHALY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:MAGDY
Authorized Official - Middle Name:ADLY
Authorized Official - Last Name:GHALY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-516-0707
Mailing Address - Street 1:2141 OAK TREE RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1044
Mailing Address - Country:US
Mailing Address - Phone:732-516-0707
Mailing Address - Fax:732-516-0088
Practice Address - Street 1:204 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08835-1806
Practice Address - Country:US
Practice Address - Phone:908-722-2992
Practice Address - Fax:908-725-5394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ50782207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1758403Medicaid
GH578315Medicare ID - Type Unspecified
NJ1758403Medicaid