Healthcare Provider Details

I. General information

NPI: 1609796648
Provider Name (Legal Business Name): ELITE DIAGNOSTICS & THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

485 US-1 BUILDING A STE 200B
ISELIN NJ
08830
US

IV. Provider business mailing address

485 US-1 BUILDING A STE 200B
ISELIN NJ
08830
US

V. Phone/Fax

Practice location:
  • Phone: 732-301-4041
  • Fax: 732-828-8877
Mailing address:
  • Phone: 732-301-4041
  • Fax: 732-828-8877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State

VIII. Authorized Official

Name: AHMED KHAWAJA
Title or Position: CEO
Credential:
Phone: 347-346-0000