Provider Demographics
NPI:1477768802
Name:HAMMOUS, AYAMAN
Entity Type:Individual
Prefix:
First Name:AYAMAN
Middle Name:
Last Name:HAMMOUS
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 1:27 PERSHING ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-4429
Mailing Address - Country:US
Mailing Address - Phone:718-448-1861
Mailing Address - Fax:718-448-1861
Practice Address - Street 1:27 PERSHING ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-4429
Practice Address - Country:US
Practice Address - Phone:718-448-1861
Practice Address - Fax:718-448-1861
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014963174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist