Provider Demographics
NPI:1184898959
Name:ELTALAWI, NANCY M
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:M
Last Name:ELTALAWI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:M
Other - Last Name:ELTALAWI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:529 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-3309
Mailing Address - Country:US
Mailing Address - Phone:932-227-1517
Mailing Address - Fax:
Practice Address - Street 1:529 4TH AVE
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-3309
Practice Address - Country:US
Practice Address - Phone:932-227-1517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA45687207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology