Healthcare Provider Details

I. General information

NPI: 1295509529
Provider Name (Legal Business Name): MARISSA OGNIBENE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2023
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ENGLISH CREEK AVE BLDG 400, 2ND FL
EGG HARBOR TOWNSHIP NJ
08234
US

IV. Provider business mailing address

2500 ENGLISH CREEK AVE BLDG 400, 2ND FL
EGG HARBOR TOWNSHIP NJ
08234
US

V. Phone/Fax

Practice location:
  • Phone: 609-677-7777
  • Fax: 609-677-7727
Mailing address:
  • Phone: 609-677-7777
  • Fax: 609-677-7727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number26NR21083500
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ15185300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: