Individual
DR. AZZA ELBASTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, FAAP
Contact information
Practice address
100 COMMONS WAY, STE 130, HOLMDEL, NJ 07733-2934
(732) 615-0700
(732) 615-9152
Mailing address
100 COMMONS WAY, STE 130, HOLMDEL, NJ 07733-2934
(732) 615-0700
(732) 615-9152
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MA058872
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6205305
—
NJ
Enumeration date
11/30/2006
Last updated
07/08/2007
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