Provider Demographics
NPI:1699776179
Name:ABDELMALEK, MOHEB S (MD)
Entity type:Individual
Prefix:DR
First Name:MOHEB
Middle Name:S
Last Name:ABDELMALEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 GEORGE ALLEN CT
Mailing Address - Street 2:
Mailing Address - City:MONROE TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-3675
Mailing Address - Country:US
Mailing Address - Phone:908-227-0483
Mailing Address - Fax:732-656-5112
Practice Address - Street 1:530 NEW BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-3674
Practice Address - Country:US
Practice Address - Phone:732-442-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06009600207P00000X
PAMD452841207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6323901Medicaid
NJ538862BPFMedicare PIN
NJ538862Medicare ID - Type Unspecified
NJF90386Medicare UPIN
NJ6323901Medicaid