Provider Demographics
NPI:1598181984
Name:HASHIMI, PATIMA (PA)
Entity Type:Individual
Prefix:
First Name:PATIMA
Middle Name:
Last Name:HASHIMI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 DOSORIS WAY
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2602
Mailing Address - Country:US
Mailing Address - Phone:516-724-4377
Mailing Address - Fax:
Practice Address - Street 1:150 55TH ST
Practice Address - Street 2:STATION 3-03
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-2508
Practice Address - Country:US
Practice Address - Phone:718-630-6808
Practice Address - Fax:718-630-8894
Is Sole Proprietor?:No
Enumeration Date:2014-03-10
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017287363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant