Provider Demographics
NPI:1154483436
Name:BASSIL, GHASSAN G (MD)
Entity Type:Individual
Prefix:DR
First Name:GHASSAN
Middle Name:G
Last Name:BASSIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 HERRMAN WAY
Mailing Address - Street 2:
Mailing Address - City:TOWACO
Mailing Address - State:NJ
Mailing Address - Zip Code:07082-1500
Mailing Address - Country:US
Mailing Address - Phone:973-365-4470
Mailing Address - Fax:973-473-3367
Practice Address - Street 1:350 BOULEVARD
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-2840
Practice Address - Country:US
Practice Address - Phone:973-365-4470
Practice Address - Fax:973-473-3367
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04361600207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ015RD1OtherEMPIRE BC/BS OF NY CLIFTON
NJ2862682000OtherAMERIHEALTH
NJ3K5166OtherHEALTHNET
NJ0145725OtherGHI PPO
NJP00404009OtherRAILROAD MEDICARE
NJ015RD3OtherEMPIRE BC/BS OF NY WAYNE
NJ015RD2OtherEMPIRE BC/BS OF NY W PATERSON
NJP00404009OtherRAILROAD MEDICARE
NJ3K5166OtherHEALTHNET