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General NPI Number Information
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NPI Number | 1346225885
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Entity Type | Individual
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Provider Name | ALI GABER MANSOUR M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/07/2005
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 90 ROUTE 22
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City | SPRINGFIELD
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State | NJ
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Zip | 07081-3110
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Country | US
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Telephone | 973-467-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 40 SAPPHIRE LN
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City | FRANKLIN PARK
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State | NJ
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Zip | 08823-1631
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Country | US
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Telephone | 646-856-3436
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA07554700
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License Number State | NJ
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