Provider Demographics
NPI:1033152707
Name:HASSON, MARIE ELENA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIE ELENA
Middle Name:
Last Name:HASSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARIE ELENA
Other - Middle Name:
Other - Last Name:HUDZICKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:128 CREST HAVEN RD
Mailing Address - Street 2:DEPARTMENT OF PSYCHIATRY MAINLAND DIVISION
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-1651
Mailing Address - Country:US
Mailing Address - Phone:609-652-3551
Mailing Address - Fax:609-404-7686
Practice Address - Street 1:ATLANTICARE REGIONAL MEDICAL CENTER JIMMIE LEEDS RD
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY MAINLAND DIVISION
Practice Address - City:POMONA
Practice Address - State:NJ
Practice Address - Zip Code:08240
Practice Address - Country:US
Practice Address - Phone:609-652-3551
Practice Address - Fax:609-404-7686
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA674722084P0800X
PAMD063696L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1093873556OtherGROUP NPI, ATLANTICARE BEHAVIORAL HEALTH
NJ1093873556OtherGROUP NPI, ATLANTICARE BEHAVIORAL HEALTH
NJG96028Medicare UPIN