Provider Demographics
NPI:1235364555
Name:HASNAIN, MUJTABA ALI (MD)
Entity Type:Individual
Prefix:
First Name:MUJTABA
Middle Name:ALI
Last Name:HASNAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:62 HACKETT BLVD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12209-1756
Mailing Address - Country:US
Mailing Address - Phone:518-434-2244
Mailing Address - Fax:518-434-4659
Practice Address - Street 1:1 WEST AVE
Practice Address - Street 2:SUITE 155
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-6045
Practice Address - Country:US
Practice Address - Phone:518-581-0112
Practice Address - Fax:518-580-9876
Is Sole Proprietor?:No
Enumeration Date:2009-05-17
Last Update Date:2015-07-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY265897207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology