Provider Demographics
NPI:1356854251
Name:HAKIM, ASAL (RD, CDN)
Entity Type:Individual
Prefix:
First Name:ASAL
Middle Name:
Last Name:HAKIM
Suffix:
Gender:F
Credentials:RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 JOHN BEAN CT
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-4628
Mailing Address - Country:US
Mailing Address - Phone:516-260-1202
Mailing Address - Fax:516-686-9526
Practice Address - Street 1:585 STEWART AVENUE SUITE LL-18
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4784
Practice Address - Country:US
Practice Address - Phone:516-260-1202
Practice Address - Fax:516-686-9526
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-14
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009082133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered