Individual
DR. MATTHEW EVAN BASSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
330 RATZER RD STE B7, WAYNE, NJ 07470-7704
(973) 317-0155
(973) 317-0149
Mailing address
PO BOX 416457, BOSTON, MA 02241-6457
(844) 362-1735
(973) 290-7495
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25MB09755400
NJ
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
25MB09755400
NJ
Other
Enumeration date
03/04/2014
Last updated
09/04/2020
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