Provider Demographics
NPI:1013802024
Name:MAHROUS, SAMEH THABET
Entity type:Individual
Prefix:
First Name:SAMEH
Middle Name:THABET
Last Name:MAHROUS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:646 HIGHWAY 18 STE 104A
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3722
Mailing Address - Country:US
Mailing Address - Phone:732-231-4293
Mailing Address - Fax:786-432-1366
Practice Address - Street 1:646 HIGHWAY 18 STE 104A
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3722
Practice Address - Country:US
Practice Address - Phone:732-231-4293
Practice Address - Fax:786-432-1366
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator