MEDICARE: MOHAMED ABOELENIN PA-C

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	363AM0700X	Medical Physician Assistant	25MP00853900	NJ

General Provider Information

NPI Number	:	1689412512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMED ABOELENIN PA-C

Provider Business Mailing Address
First Line	:	2317 US HIGHWAY 22 CTR
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-8558
Country	:	US
Telephone Number	:	201-354-1951
Fax Number	:

Provider Business Practice Location Address
First Line	:	2317 US HIGHWAY 22 CTR
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-8558
Country	:	US
Telephone Number	:	201-354-1951
Fax Number	:

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

Provider Enumeration Date	:	07/16/2024
Last Update Date	:	04/16/2026

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Directions to “ MOHAMED ABOELENIN PA-C” Practice Location

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