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Amanda Christina Abou Ezzi I, M.D.

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Jersey City, NJ

NPI 1285093641 · NPPES record last updated Feb 15, 2016

Key facts

NPI
1285093641
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
30 River CT
Apt 2302
Jersey City, NJ 07310
Phone
(201) 565-6757
NPI assigned
Feb 15, 2016
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
J.P. Makhlouf M.D. F.a.Ap. Tiziana Anello M.D F.a.a.P P.a. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

30 River CT
Apt 2302
Jersey City, NJ 07310

Mailing address

30 River CT Apt 2302
Jersey City, NJ 07310-2110

Other names

  • Dr. Amanda Christina Abou Ezzi Professional name

Other providers in Jersey City, NJ

All providers in Jersey City, NJ · Student in an Organized Health Care Education/Training Program in New Jersey

Sources for this page

Verify at the official NPI Registry.