Provider Demographics
NPI:1851331680
Name:GHACIBEH, GEORGES A (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGES
Middle Name:A
Last Name:GHACIBEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:381 PARK ST.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-4350
Mailing Address - Country:US
Mailing Address - Phone:201-546-8510
Mailing Address - Fax:201-957-7316
Practice Address - Street 1:381 PARK ST.
Practice Address - Street 2:SUITE 200
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-4350
Practice Address - Country:US
Practice Address - Phone:201-546-8510
Practice Address - Fax:201-957-7316
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA082320002084E0001X, 2084N0600X, 2084S0012X, 2084N0400X
FLME849392084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084E0001XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyEpilepsy
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269611800Medicaid
NJ0143731Medicaid
FL269611800Medicaid