Provider Demographics
NPI:1952310658
Name:ASSAD, EVELINE NABIL (MD)
Entity Type:Individual
Prefix:DR
First Name:EVELINE
Middle Name:NABIL
Last Name:ASSAD
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 1:1 STILES LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08823-1749
Mailing Address - Country:US
Mailing Address - Phone:732-951-0814
Mailing Address - Fax:
Practice Address - Street 1:6 CORNWALL COURT
Practice Address - Street 2:SUITES A & B
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816
Practice Address - Country:US
Practice Address - Phone:732-390-5550
Practice Address - Fax:732-390-0550
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03821100207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE54129Medicare UPIN