Provider Demographics
NPI:1952358178
Name:SANGOSSE, MARIE C (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:C
Last Name:SANGOSSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:745 NORTHFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1144
Mailing Address - Country:US
Mailing Address - Phone:973-731-0200
Mailing Address - Fax:973-325-2244
Practice Address - Street 1:745 NORTHFIELD AVE
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1144
Practice Address - Country:US
Practice Address - Phone:973-731-0200
Practice Address - Fax:973-325-2244
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA04902900207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology