Healthcare Provider Details

I. General information

NPI: 1285791905
Provider Name (Legal Business Name): SAADI GHATAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 03/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 10TH AVE SUITE 5G-80
NEW YORK NY
10019-1147
US

IV. Provider business mailing address

PO BOX 95000-5420
PHILADELPHIA PA
19195-5420
US

V. Phone/Fax

Practice location:
  • Phone: 212-636-3232
  • Fax:
Mailing address:
  • Phone: 212-636-3232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number227303-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number25MA07796800
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number227303-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: