Provider Demographics
NPI:1437536349
Name:HASSAN, SHADWA ELSAYED (DO)
Entity Type:Individual
Prefix:DR
First Name:SHADWA
Middle Name:ELSAYED
Last Name:HASSAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14 SNOWHILL ST STE A
Mailing Address - Street 2:
Mailing Address - City:SPOTSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08884-1358
Mailing Address - Country:US
Mailing Address - Phone:732-956-8934
Mailing Address - Fax:732-347-7731
Practice Address - Street 1:14 SNOWHILL ST STE A
Practice Address - Street 2:
Practice Address - City:SPOTSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08884-1358
Practice Address - Country:US
Practice Address - Phone:732-956-8934
Practice Address - Fax:732-347-7731
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-29
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY294085208000000X
NJ25MB10912700208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics