Provider Demographics
NPI:1417062845
Name:HASEN, JULIAN (MD)
Entity Type:Individual
Prefix:
First Name:JULIAN
Middle Name:
Last Name:HASEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 ROLAND DR
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605
Mailing Address - Country:US
Mailing Address - Phone:914-949-8311
Mailing Address - Fax:914-949-8311
Practice Address - Street 1:3 ROLAND DR
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-5406
Practice Address - Country:US
Practice Address - Phone:914-949-8311
Practice Address - Fax:914-949-8311
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY096704207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00478611Medicaid
NY00478611Medicaid
C12370Medicare UPIN