Individual
DR. ISSAM KOLEILAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
67 ROUTE 37 W STE 200B, TOMS RIVER, NJ 08755-6400
(732) 341-3647
Mailing address
67 ROUTE 37 W STE 200B, TOMS RIVER, NJ 08755-6400
(732) 341-3647
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
25MA09883400
NJ
2086S0129X
Vascular Surgery Physician
Primary
25MA09883400
NJ
2086S0129X
Vascular Surgery Physician
279895
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
62732
AMC ID NUMBER
—
Enumeration date
06/17/2008
Last updated
04/30/2024
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