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General NPI Number Information
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NPI Number | 1295509529
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Entity Type | Individual
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Provider Name | MARISSA OGNIBENE NP
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Gender | Female
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Dates
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Enumeration Date | 11/07/2023
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 2500 ENGLISH CREEK AVE BLDG 400, 2ND FL
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City | EGG HARBOR TOWNSHIP
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State | NJ
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Zip | 08234
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Country | US
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Telephone | 609-677-7777
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Fax | 609-677-7727
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Provider Business Mailing Address
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Address Line | 2500 ENGLISH CREEK AVE BLDG 400, 2ND FL
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City | EGG HARBOR TOWNSHIP
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State | NJ
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Zip | 08234
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Country | US
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Telephone | 609-677-7777
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Fax | 609-677-7727
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 26NJ15185300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 26NR21083500
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License Number State | NJ
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