Provider Demographics
NPI:1396388872
Name:HASSAN, AYAN M
Entity Type:Individual
Prefix:
First Name:AYAN
Middle Name:M
Last Name:HASSAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4351 DONEGAL CHURCH CT
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-1310
Mailing Address - Country:US
Mailing Address - Phone:202-210-6704
Mailing Address - Fax:
Practice Address - Street 1:4351 DONEGAL CHURCH CT
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-1310
Practice Address - Country:US
Practice Address - Phone:703-951-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-28
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide