Healthcare Provider Details

I. General information

NPI: 1215844824
Provider Name (Legal Business Name): ELI MEDICAL NJ PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 CARDINAL WAY STE 900
SAINT LOUIS MO
63102-2807
US

IV. Provider business mailing address

6 CARDINAL WAY STE 900
SAINT LOUIS MO
63102-2807
US

V. Phone/Fax

Practice location:
  • Phone: 917-771-7295
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ALEX MOHSENI
Title or Position: PRESIDENT
Credential: MD
Phone: 917-771-7295