Eltayeb Idris Massabbal, M. D.

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

25MA08089700 Issued in NJ

Practice address

333 Irving Ave.
Bridgeton, NJ 08302-2123

Phone

(856) 451-6600

Fax

(302) 651-4945

NPI assigned

Aug 16, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Inspira Medical Centers, Inc.

  dba Inspira Medical Center Vineland

  • General Acute Care Hospital
  • Vineland, NJ
  • NPI 1164487542
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1376656488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 191",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197230191",
            "telephone_number": "302-651-4000",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 IRVING AVE.",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "083022123",
            "telephone_number": "856-451-6600",
            "fax_number": "302-651-4945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSABBAL",
        "first_name": "ELTAYEB",
        "middle_name": "IDRIS",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "PA",
            "license": "MD444793",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NJ",
            "license": "25MA08089700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDS",
            "identifier": "D08906700",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Marks
• Rita Maroldo, APRN
• Christianna R Martin, LCSW
• Nancy Martin, LCSW
• Maria Martinez, PA
• Gayle A Maxwell, APN
• Glenda Mazza, LPN
• Linda D McBride, DDS
• Andrea McCoy, LPN
• John McGlynn, D.M.D.

• Neonatal-Perinatal Medicine Physician in Bridgeton, NJ
• Providers in Bridgeton, NJ by specialty
• Neonatal-Perinatal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.