| Elsaid Balboul Md Pa | |
|
508 Hamburg Tpke Ste 201 Wayne NJ 07470-8482 | |
| (973) 942-1340 | |
| Not Available |
| Full Name | Elsaid Balboul Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 508 Hamburg Tpke, Wayne, New Jersey |
| Authorized Official Name and Position | Elsaid Balboul (OWNER) |
| Authorized Official Contact | 9739421340 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elsaid Balboul Md Pa 508 Hamburg Tpke Ste 201 Wayne NJ 07470-8482 Ph: (973) 942-1340 | Elsaid Balboul Md Pa 508 Hamburg Tpke Ste 201 Wayne NJ 07470-8482 Ph: (973) 942-1340 |
| NPI Number | 1265487086 |
|---|---|
| Provider Enumeration Date | 05/23/2006 |
| Last Update Date | 08/15/2008 |
| Medicare PECOS PAC ID | 6709951403 |
|---|---|
| Medicare Enrollment ID | O20080814000434 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265487086 | NPI | - | NPPES |
| 9056301 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MA59362 (New Jersey) | Primary |
| Provider Name | Elsaid A Balboul |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467421339 PECOS PAC ID: 7214923580 Enrollment ID: I20040422000343 |
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