Provider Demographics
NPI:1184415606
Name:ABDEL-MASEIH, JEROME DANIEL (D0)
Entity type:Individual
Prefix:DR
First Name:JEROME
Middle Name:DANIEL
Last Name:ABDEL-MASEIH
Suffix:
Gender:M
Credentials:D0
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 LEE ST
Mailing Address - Street 2:
Mailing Address - City:PORT READING
Mailing Address - State:NJ
Mailing Address - Zip Code:07064-1613
Mailing Address - Country:US
Mailing Address - Phone:732-947-7420
Mailing Address - Fax:
Practice Address - Street 1:176 PALISADE AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-1196
Practice Address - Country:US
Practice Address - Phone:201-795-8201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJA10173960004982390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program