Provider Demographics
NPI:1427031681
Name:BORAI, NASSER ELDIEN (MD)
Entity type:Individual
Prefix:DR
First Name:NASSER
Middle Name:ELDIEN
Last Name:BORAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:54 W JIMMIE LEEDS RD
Mailing Address - Street 2:SUITES 11 &12
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-9401
Mailing Address - Country:US
Mailing Address - Phone:609-404-9966
Mailing Address - Fax:609-404-9967
Practice Address - Street 1:54 W JIMMIE LEEDS RD
Practice Address - Street 2:SUITES 11 & 12
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9401
Practice Address - Country:US
Practice Address - Phone:609-404-9966
Practice Address - Fax:609-404-9967
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05533500207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6552200Medicaid
830007154OtherPALMETTO GBA/RR MEDICARE
5178380001OtherHEALTH NOW NY/DMERC A
5178380001OtherHEALTH NOW NY/DMERC A
NJ6552200Medicaid