Provider Demographics
NPI:1053834150
Name:NEURODEVELOPMENTAL ANALYSIS SURVEILLANCE THERAPEUTICS PC
Entity Type:Organization
Organization Name:NEURODEVELOPMENTAL ANALYSIS SURVEILLANCE THERAPEUTICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:RAZI
Authorized Official - Middle Name:
Authorized Official - Last Name:HASAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-499-1980
Mailing Address - Street 1:2843 S COUNTY TRL STE 112
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-1753
Mailing Address - Country:US
Mailing Address - Phone:401-499-1980
Mailing Address - Fax:
Practice Address - Street 1:2843 S COUNTY TRL STE 112
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1753
Practice Address - Country:US
Practice Address - Phone:401-499-1980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0008XAllopathic & Osteopathic PhysiciansPediatricsNeurodevelopmental DisabilitiesGroup - Single Specialty