MEDICARE: DR. GHASSAN NAHAS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	29183	NJ

General Provider Information

NPI Number	:	1700979044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GHASSAN NAHAS MD

Provider Business Mailing Address
First Line	:	255 STATE RT 3 STE 200
Second Line	:
City	:	SECAUCUS
State	:	NJ
Zip	:	07094-3857
Country	:	US
Telephone Number	:	201-864-2389
Fax Number	:

Provider Business Practice Location Address
First Line	:	255 STATE RT 3 STE 200
Second Line	:
City	:	SECAUCUS
State	:	NJ
Zip	:	07094-3857
Country	:	US
Telephone Number	:	201-864-2389
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2006
Last Update Date	:	07/08/2007

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