Provider Demographics
NPI:1902833312
Name:CAMAL, DEBRA ELLEN (MD)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:ELLEN
Last Name:CAMAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 MONMOUTH RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-1500
Mailing Address - Country:US
Mailing Address - Phone:732-531-5200
Mailing Address - Fax:732-531-5836
Practice Address - Street 1:257 MONMOUTH RD
Practice Address - Street 2:SUITE 2
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-1500
Practice Address - Country:US
Practice Address - Phone:732-531-5200
Practice Address - Fax:732-531-5836
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 55487208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG22813Medicare UPIN
730143Medicare ID - Type Unspecified