Provider Demographics
NPI:1295509529
Name:OGNIBENE, MARISSA (NP)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:
Last Name:OGNIBENE
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 1:2500 ENGLISH CREEK AVE
Mailing Address - Street 2:BLDG 400, 2ND FL
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234
Mailing Address - Country:US
Mailing Address - Phone:609-677-7777
Mailing Address - Fax:609-677-7727
Practice Address - Street 1:2500 ENGLISH CREEK AVE
Practice Address - Street 2:BLDG 400, 2ND FL
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234
Practice Address - Country:US
Practice Address - Phone:609-677-7777
Practice Address - Fax:609-677-7727
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR21083500163WM0705X
NJ26NJ15185300363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical