Provider Demographics
NPI:1396809976
Name:NAHED EL-KHOLY MD LLC
Entity type:Organization
Organization Name:NAHED EL-KHOLY MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NAHED
Authorized Official - Middle Name:
Authorized Official - Last Name:EL-KHOLY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-384-0739
Mailing Address - Street 1:11 WINDSOR DR
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-2325
Mailing Address - Country:US
Mailing Address - Phone:973-384-0739
Mailing Address - Fax:973-383-5323
Practice Address - Street 1:93 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-2056
Practice Address - Country:US
Practice Address - Phone:973-384-0739
Practice Address - Fax:973-383-5323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA049573305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ135379Medicare PIN