Provider Demographics
NPI:1528005907
Name:HASAN, ZEESHAN SULTANA (MD)
Entity Type:Individual
Prefix:DR
First Name:ZEESHAN
Middle Name:SULTANA
Last Name:HASAN
Suffix:
Gender:F
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:PO BOX 304
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11582-0304
Mailing Address - Country:US
Mailing Address - Phone:516-285-1270
Mailing Address - Fax:516-285-1271
Practice Address - Street 1:2 ARKANSAS DR
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580
Practice Address - Country:US
Practice Address - Phone:516-285-1270
Practice Address - Fax:516-285-1271
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2018-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219511207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02149580Medicaid
NY02149580Medicaid
NYA100085270Medicare PIN
NYH48416Medicare UPIN
NYA400085271Medicare PIN
NY119SPEZ791Medicare PIN
NY119SPEZ791Medicare PIN
NY07160Medicare PIN