Provider Demographics
NPI:1437112091
Name:HASSUMANI, JANICE P (MD)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:P
Last Name:HASSUMANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6401 UNIVERSITY AVE NE
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-4341
Mailing Address - Country:US
Mailing Address - Phone:763-572-5710
Mailing Address - Fax:763-571-3008
Practice Address - Street 1:6341 UNIVERSITY AVE NE
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-4946
Practice Address - Country:US
Practice Address - Phone:763-572-5710
Practice Address - Fax:763-586-5888
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN26244207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN107293OtherUCARE MN
MN1000860OtherPREFERRED ONE
MN20846OtherAMERICA'S PPO
MN0108790OtherMEDICA
MN4044520OtherAETNA
MN6603869OtherMEDICA UC
MN08F33HAOtherBCBS OF MN
MNHP19861OtherHEALTHPARTNERS
MNA95910Medicare UPIN