Provider Demographics
NPI:1407152150
Name:HENRY HASSON M.D., P.C.
Entity Type:Organization
Organization Name:HENRY HASSON M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-785-9828
Mailing Address - Street 1:2769 CONEY ISLAND AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-5061
Mailing Address - Country:US
Mailing Address - Phone:718-785-9828
Mailing Address - Fax:718-425-0964
Practice Address - Street 1:2769 CONEY ISLAND AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5061
Practice Address - Country:US
Practice Address - Phone:718-785-9828
Practice Address - Fax:718-425-0964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-27
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY240365261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty