Healthcare Provider Details

I. General information

NPI: 1114926664
Provider Name (Legal Business Name): SAEED ABBASSI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 10/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7827 BERGENLINE AVE
NORTH BERGEN NJ
07047-4942
US

IV. Provider business mailing address

7827 BERGEN LINE AVE
NORTH BERGEN NJ
07047-6201
US

V. Phone/Fax

Practice location:
  • Phone: 201-868-1950
  • Fax: 201-868-5844
Mailing address:
  • Phone: 201-868-1950
  • Fax: 201-868-5844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA04127600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: