Organization
ELSAID BALBOUL MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELSAID BALBOUL MD (OWNER)
(973) 942-1340
Entity
Organization
Contact information
Practice address
508 HAMBURG TPKE, STE 201, WAYNE, NJ 07470-8482
(973) 942-1340
Mailing address
508 HAMBURG TPKE, STE 201, WAYNE, NJ 07470-8482
(973) 942-1340
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA59362
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9056301
—
NJ
Enumeration date
05/23/2006
Last updated
08/15/2008
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