Provider Demographics
NPI:1124275094
Name:GHANNY, STEVEN NIGEL (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:NIGEL
Last Name:GHANNY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:30 PROSPECT AVENUE
Mailing Address - Street 2:PC251
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1914
Mailing Address - Country:US
Mailing Address - Phone:551-996-5329
Mailing Address - Fax:551-996-0115
Practice Address - Street 1:30 PROSPECT AVENUE
Practice Address - Street 2:PC251
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1914
Practice Address - Country:US
Practice Address - Phone:551-996-5329
Practice Address - Fax:551-996-0115
Is Sole Proprietor?:No
Enumeration Date:2008-08-22
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08425500208000000X, 2080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics