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Individual

ELTAYEB IDRIS MASSABBAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M. D.

Contact information

Practice address
333 IRVING AVE., BRIDGETON, NJ 08302-2123
(856) 451-6600
(302) 651-4945
Mailing address
P.O. BOX 191, ROCKLAND, DE 19723-0191
(302) 651-4000
(302) 651-4945

Taxonomy

Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
25MA08089700
NJ
2080N0001X
Neonatal-Perinatal Medicine Physician
MD444793
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D08906700
CDS
NJ
Enumeration date
08/16/2006
Last updated
07/27/2023
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