Provider Demographics
NPI:1841336989
Name:DR. MAGDY NASRA MD PC
Entity type:Organization
Organization Name:DR. MAGDY NASRA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAGDY
Authorized Official - Middle Name:
Authorized Official - Last Name:NASRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-888-8255
Mailing Address - Street 1:723 N BEERS ST
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1517
Mailing Address - Country:US
Mailing Address - Phone:732-888-8255
Mailing Address - Fax:732-888-7682
Practice Address - Street 1:723 N BEERS ST
Practice Address - Street 2:SUITE2 C
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1517
Practice Address - Country:US
Practice Address - Phone:732-888-8255
Practice Address - Fax:732-888-7682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA059343174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty