Provider Demographics
NPI:1609138759
Name:KAHSSAY, HABTEKIROS T (CRNA)
Entity Type:Individual
Prefix:
First Name:HABTEKIROS
Middle Name:T
Last Name:KAHSSAY
Suffix:
Gender:M
Credentials:CRNA
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:364 HATFIELD ST
Mailing Address - Street 2:APT B
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2553
Mailing Address - Country:US
Mailing Address - Phone:413-588-2227
Mailing Address - Fax:
Practice Address - Street 1:690 CANTON ST
Practice Address - Street 2:SUITE 325
Practice Address - City:WESTWOOD
Practice Address - State:MA
Practice Address - Zip Code:02090-2321
Practice Address - Country:US
Practice Address - Phone:781-407-7713
Practice Address - Fax:781-407-0998
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2013-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA2278438367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered