Individual
ALISA MARGARET GHANAIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1005 N WASHINGTON AVE, GREEN BROOK, NJ 08812-2698
(732) 968-8900
Mailing address
2150 PERRINE RD, MARTINSVILLE, NJ 08836-2305
(732) 397-8082
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00727000
NJ
Other
Enumeration date
08/18/2022
Last updated
08/18/2022
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