MEDICARE: ELSAYED A SAHLOUL 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	207R00000X	Internal Medicine Physician	25MA07118000	NJ
2	207RI0008X	Hepatology Physician	25MA071180	NJ
3	208M00000X	Hospitalist Physician	MD451598	PA

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467452565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELSAYED A SAHLOUL MD

Provider Business Mailing Address
First Line	:	1 BETHANY RD
Second Line	:	BLDG #2, STE #25
City	:	HAZLET
State	:	NJ
Zip	:	07730-1660
Country	:	US
Telephone Number	:	732-217-3208
Fax Number	:	732-217-3107

Provider Business Practice Location Address
First Line	:	1 BETHANY RD
Second Line	:	BLDG #2, STE #25
City	:	HAZLET
State	:	NJ
Zip	:	07730-1660
Country	:	US
Telephone Number	:	732-217-3208
Fax Number	:	732-217-3107

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

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	12/26/2023

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Directions to “ ELSAYED A SAHLOUL MD” Practice Location

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