Provider Demographics
NPI:1437543386
Name:HASHEMI, SOROOSH (MD)
Entity Type:Individual
Prefix:DR
First Name:SOROOSH
Middle Name:
Last Name:HASHEMI
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 1:19 S MAIN ST STE B4-2
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-1510
Mailing Address - Country:US
Mailing Address - Phone:215-715-6187
Mailing Address - Fax:
Practice Address - Street 1:19 S MAIN ST STE B4-2
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-1510
Practice Address - Country:US
Practice Address - Phone:215-715-6187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-27
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD466102207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine