Provider Demographics
NPI:1003981515
Name:HASAN, MOHAMMAD ASHRAF (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:ASHRAF
Last Name:HASAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2495 NEWBRIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710
Mailing Address - Country:US
Mailing Address - Phone:516-221-3855
Mailing Address - Fax:516-781-8248
Practice Address - Street 1:2495 NEWBRIDGE ROAD
Practice Address - Street 2:
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710
Practice Address - Country:US
Practice Address - Phone:516-221-3855
Practice Address - Fax:516-781-8248
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY115135207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
48249OtherAETNA
4865OtherUNITED HEALTHCARE
AP708OtherOXFORD
2C7852OtherHEALTHNET
432273NOtherCIGNA
NY112394819Other1199
21132OtherVYTRA
112394819OtherMAGNACARE
AB47496OtherMDNY
112394819OtherEMPIRE GOVT
5383378OtherCIGNA
563551OtherEMPIRE BCBS
0085788OtherGHI
502545OtherAETNA
NY112394819Other1199
502545OtherAETNA