Provider Demographics
NPI:1033591888
Name:HAKKIM, ANSI (MD)
Entity Type:Individual
Prefix:
First Name:ANSI
Middle Name:
Last Name:HAKKIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:478 WASHINGTON AVE
Mailing Address - Street 2:#1A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-1821
Mailing Address - Country:US
Mailing Address - Phone:347-909-3102
Mailing Address - Fax:
Practice Address - Street 1:478 WASHINGTON AVE
Practice Address - Street 2:#1A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-1821
Practice Address - Country:US
Practice Address - Phone:347-909-3102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-28
Last Update Date:2015-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program