Provider Demographics
NPI:1518377951
Name:HASAN, SAQIF MOHAMMAD TAREK (MD)
Entity Type:Individual
Prefix:
First Name:SAQIF
Middle Name:MOHAMMAD TAREK
Last Name:HASAN
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 1:8726 175TH STREET
Mailing Address - Street 2:APT#3D
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-5612
Mailing Address - Country:US
Mailing Address - Phone:917-769-8221
Mailing Address - Fax:
Practice Address - Street 1:10201 66TH ROAD
Practice Address - Street 2:NORTHWELL FOREST HILLS HOSPITAL
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374
Practice Address - Country:US
Practice Address - Phone:718-830-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-07
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHLT3616207R00000X
MTMED-PHYS-LIC-43863207R00000X
NY282648207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine