Provider Demographics
NPI:1235517129
Name:ALHADDAD PHYSICIAN SERVICES
Entity Type:Organization
Organization Name:ALHADDAD PHYSICIAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:BASAL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALHADDAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-733-3255
Mailing Address - Street 1:8407 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-3201
Mailing Address - Country:US
Mailing Address - Phone:347-733-3255
Mailing Address - Fax:718-491-2007
Practice Address - Street 1:466 BAY RIDGE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-5906
Practice Address - Country:US
Practice Address - Phone:718-491-2003
Practice Address - Fax:718-491-2007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY248285174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty