Provider Demographics
NPI:1609203991
Name:ALHASSAN, MUNIRATU I (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:MUNIRATU
Middle Name:
Last Name:ALHASSAN
Suffix:I
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:DUMONT
Mailing Address - State:NJ
Mailing Address - Zip Code:07628-1020
Mailing Address - Country:US
Mailing Address - Phone:201-417-5728
Mailing Address - Fax:
Practice Address - Street 1:535 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:DUMONT
Practice Address - State:NJ
Practice Address - Zip Code:07628-1020
Practice Address - Country:US
Practice Address - Phone:201-417-5728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF338305-1363LF0000X
NJ26NJ00438900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily