Provider Demographics
NPI:1750819157
Name:ELKOUN, SOUHAIB
Entity Type:Individual
Prefix:
First Name:SOUHAIB
Middle Name:
Last Name:ELKOUN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 PARKER RD # B-02
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-2148
Mailing Address - Country:US
Mailing Address - Phone:973-842-2488
Mailing Address - Fax:732-343-6878
Practice Address - Street 1:40 PARKER RD # B-02
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208-2148
Practice Address - Country:US
Practice Address - Phone:973-842-2488
Practice Address - Fax:732-343-6878
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker