Moubarak, Issam F.
Moubarak, Issam F. is an sole proprietor health care provider with primary practice located at 579A Cranbury Rd University Radiology Group, Pc, East Brunswick NJ 08816-5426. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Moubarak, Issam F. can be contacted via phone (732) 390-0040.Contact Information
Primary practice address
579A Cranbury Rd University Radiology Group, Pc
East Brunswick NJ 08816-5426
Phone: (732) 390-0040
Fax: (732) 390-1856
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | MD070556L | Pennsylvania |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | MD070556L | Pennsylvania |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 25MA06501100 | New Jersey |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 25MA06501100 | New Jersey |
Profile Details
| NPI number | 1639176084 |
|---|---|
| LBN Legal business name | Moubarak, Issam F. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 30th, 2005 |
| Last updated | Jan 18th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639176084 | NPPES |
| Pennsylvania | MEDICAID | 102213146-0001 | |
| Pennsylvania | MEDICAID | 03092940 | |
| Pennsylvania | MEDICAID | 8132801 |
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