MEDICARE: IBRAHIM ELKATTAWY

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	213ES0103X	Foot & Ankle Surgery Podiatrist	25MD00359200	NJ

General Provider Information

NPI Number	:	1861980138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IBRAHIM ELKATTAWY

Provider Business Mailing Address
First Line	:	2761 JOHN F KENNEDY BLVD
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-5515
Country	:	US
Telephone Number	:	201-707-1378
Fax Number	:

Provider Business Practice Location Address
First Line	:	2761 JOHN F KENNEDY BLVD
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-5515
Country	:	US
Telephone Number	:	201-707-1378
Fax Number	:

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

Provider Enumeration Date	:	04/23/2018
Last Update Date	:	08/11/2025

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Directions to “ IBRAHIM ELKATTAWY ” Practice Location

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