Individual
SHENOUDA IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1135 MAIN AVE, CLIFTON, NJ 07011-2353
(973) 928-3388
Mailing address
22 BERKELEY AVE, BELLEVILLE, NJ 07109-1470
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00802600
NJ
Other
Enumeration date
08/08/2023
Last updated
12/21/2023
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