Healthcare Provider Details

I. General information

NPI: 1679428163
Provider Name (Legal Business Name): OPHIR JEWEL SABAH PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 ROUTE 33 FL 4 ACKERMAN
NEPTUNE NJ
07753
US

IV. Provider business mailing address

331 NEWMAN SPRINGS RD BLDG 2, STE 220
RED BANK NJ
07701-5688
US

V. Phone/Fax

Practice location:
  • Phone: 732-776-4949
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP01001800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: