Healthcare Provider Details

I. General information

NPI: 1174905236
Provider Name (Legal Business Name): SASSINE GHANEM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2015
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ENGLISH CREEK AVE BLDG 400
EGG HARBOR TOWNSHIP NJ
08234
US

IV. Provider business mailing address

2500 ENGLISH CREEK AVE BLDG 400
EGG HARBOR TOWNSHIP NJ
08234
US

V. Phone/Fax

Practice location:
  • Phone: 609-404-7345
  • Fax: 609-652-3460
Mailing address:
  • Phone: 609-404-7345
  • Fax: 609-652-3460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number865265
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number25MA12568800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: