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NPI Code Detail

MEDICARE: RAEF A ELGAWLI M.D.

MEDICARE: RAEF A ELGAWLI M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician25MA06020200NJ

General Provider Information

NPI Number : 1528060142
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAEF A ELGAWLI M.D.
Provider Business Mailing Address
First Line : PO BOX 237
Second Line :
City : NORTHFIELD
State : NJ
Zip : 08225-0237
Country : US
Telephone Number : 609-813-2190
Fax Number :
Provider Business Practice Location Address
First Line : 6314 BLACK HORSE PIKE
Second Line :
City : EGG HARBOR TOWNSHIP
State : NJ
Zip : 08234-5543
Country : US
Telephone Number : 609-813-2190
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2005
Last Update Date : 07/08/2007

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