1841336989 NPI number — DR. MAGDY NASRA MD PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841336989 NPI number — DR. MAGDY NASRA MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR. MAGDY NASRA MD PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841336989
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/14/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
723 N BEERS ST
Provider Second Line Business Mailing Address:
SUITE 2C
Provider Business Mailing Address City Name:
HOLMDEL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07733-1517
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-888-8255
Provider Business Mailing Address Fax Number:
732-888-7682

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
723 N BEERS ST
Provider Second Line Business Practice Location Address:
SUITE2 C
Provider Business Practice Location Address City Name:
HOLMDEL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07733-1517
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-888-8255
Provider Business Practice Location Address Fax Number:
732-888-7682
Provider Enumeration Date:
01/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
NASRA
Authorized Official First Name:
MAGDY
Authorized Official Middle Name:
Authorized Official Title or Position:
BUSINESS OWNER
Authorized Official Telephone Number:
732-888-8255

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  25MA059343 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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