Provider Demographics
NPI:1942388921
Name:GHASSEMI, REX (MD, FACC)
Entity Type:Individual
Prefix:DR
First Name:REX
Middle Name:
Last Name:GHASSEMI
Suffix:
Gender:M
Credentials:MD, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 HAMBURG TPKE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2156
Mailing Address - Country:US
Mailing Address - Phone:973-942-1141
Mailing Address - Fax:973-942-1250
Practice Address - Street 1:246 HAMBURG TPKE
Practice Address - Street 2:SUITE 201
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2156
Practice Address - Country:US
Practice Address - Phone:973-942-1141
Practice Address - Fax:973-942-1250
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06212300207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6665004Medicaid
NJ6665004Medicaid
NJF44265Medicare UPIN