Provider Demographics
NPI:1184120222
Name:DOUGAN, SASCHA GABRIELLE (NP)
Entity type:Individual
Prefix:
First Name:SASCHA
Middle Name:GABRIELLE
Last Name:DOUGAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:393 MELROSE PL
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-1640
Mailing Address - Country:US
Mailing Address - Phone:646-591-4903
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:95 MADISON AVE FL B
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6092
Practice Address - Country:US
Practice Address - Phone:973-775-5115
Practice Address - Fax:973-285-7617
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00816500363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily