Provider Demographics
NPI:1437834702
Name:HASSAN, HAFIZ IBRAHIM
Entity Type:Individual
Prefix:
First Name:HAFIZ
Middle Name:IBRAHIM
Last Name:HASSAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3839 E GLENN ST APT 206
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-2352
Mailing Address - Country:US
Mailing Address - Phone:520-612-8156
Mailing Address - Fax:
Practice Address - Street 1:3839 E GLENN ST APT 206
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-2352
Practice Address - Country:US
Practice Address - Phone:520-612-8156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)