Provider Demographics
NPI:1245619030
Name:EHAB HASSANAIN MEDICAL PC
Entity Type:Organization
Organization Name:EHAB HASSANAIN MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTARATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EHAB
Authorized Official - Middle Name:A
Authorized Official - Last Name:HASSANAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-459-0266
Mailing Address - Street 1:1930 85TH STREET
Mailing Address - Street 2:APT #2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214
Mailing Address - Country:US
Mailing Address - Phone:917-459-0266
Mailing Address - Fax:631-422-7267
Practice Address - Street 1:1930 85TH ST APT 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-3148
Practice Address - Country:US
Practice Address - Phone:917-459-0266
Practice Address - Fax:631-422-7267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY266145173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Multi-Specialty