Healthcare Provider Details
I. General information
NPI: 1700318672
Provider Name (Legal Business Name): GHASSAN CHEHADEH HABIB M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/30/2017
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 COOPER PLZ
CAMDEN NJ
08103-1461
US
IV. Provider business mailing address
1 FEDERAL ST STE 200
CAMDEN NJ
08103-1088
US
V. Phone/Fax
- Phone: 856-342-2000
- Fax:
- Phone: 856-342-2000
- Fax: 732-790-0107
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0200X |
| Taxonomy | Critical Care Medicine (Internal Medicine) Physician |
| License Number | 305393 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0200X |
| Taxonomy | Critical Care Medicine (Internal Medicine) Physician |
| License Number | ME164077 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0200X |
| Taxonomy | Critical Care Medicine (Internal Medicine) Physician |
| License Number | 25MA12676400 |
| License Number State | NJ |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | 305393 |
| License Number State | NY |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 305393 |
| License Number State | NY |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | V7636 |
| Identifier Type | OTHER |
| Identifier State | FL |
| Identifier Issuer | HFMG |
| # 2 | |
| Identifier | PENDING |
| Identifier Type | MEDICAID |
| Identifier State | FL |
| Identifier Issuer | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: