Provider Demographics
NPI:1447386651
Name:HASNAIN, FARHEEN JAMIL (MD)
Entity Type:Individual
Prefix:DR
First Name:FARHEEN
Middle Name:JAMIL
Last Name:HASNAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 QUARTERMASTER CT
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3623
Mailing Address - Country:US
Mailing Address - Phone:812-288-8360
Mailing Address - Fax:812-288-8375
Practice Address - Street 1:73 QUARTERMASTER CT
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3623
Practice Address - Country:US
Practice Address - Phone:812-288-8360
Practice Address - Fax:812-288-8375
Is Sole Proprietor?:No
Enumeration Date:2007-02-24
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01059517A207R00000X
KY44371207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100383000Medicaid
IN201026140Medicaid
KY50044768OtherPASSPORT HEALTH PLAN
KY7100383000Medicaid
INP01026874Medicare PIN
KYK119330Medicare PIN