Provider Demographics
NPI:1083684492
Name:ALHASAN, HARITH (MD)
Entity Type:Individual
Prefix:
First Name:HARITH
Middle Name:
Last Name:ALHASAN
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 1:4459 AMBOY RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-3863
Mailing Address - Country:US
Mailing Address - Phone:718-948-6177
Mailing Address - Fax:718-948-8189
Practice Address - Street 1:33 WALT WHITMAN RD
Practice Address - Street 2:STE. 217
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-3640
Practice Address - Country:US
Practice Address - Phone:631-271-5070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY159252207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00894775Medicaid
NY47D841Medicare ID - Type Unspecified
NY00894775Medicaid