Healthcare Provider Details

I. General information

NPI: 1790312213
Provider Name (Legal Business Name): MARNIE ABESHOUSE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 ESSEX ST STE 303
HACKENSACK NJ
07601-8566
US

IV. Provider business mailing address

360 ESSEX ST STE 303
HACKENSACK NJ
07601-8566
US

V. Phone/Fax

Practice location:
  • Phone: 551-996-4371
  • Fax: 551-996-0456
Mailing address:
  • Phone: 551-996-4371
  • Fax: 551-996-0456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number25MA13235300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: