MEDICARE: MR. ADEL BASILY SORIAL MD

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
1	207Y00000X	Otolaryngology Physician	MA 24432	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134124357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ADEL BASILY SORIAL MD

Provider Business Mailing Address
First Line	:	36 NEWARK AVE
Second Line	:	STE 318
City	:	BELLEVILLE
State	:	NJ
Zip	:	07109-4121
Country	:	US
Telephone Number	:	973-751-2251
Fax Number	:	973-751-4445

Provider Business Practice Location Address
First Line	:	36 NEWARK AVE
Second Line	:	STE 318
City	:	BELLEVILLE
State	:	NJ
Zip	:	07109-4121
Country	:	US
Telephone Number	:	973-751-2251
Fax Number	:	973-751-4445

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	07/08/2007

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