Provider Demographics
NPI:1639175383
Name:HASSAN, JOSEPH R (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:R
Last Name:HASSAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:50 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-3335
Mailing Address - Country:US
Mailing Address - Phone:610-372-8044
Mailing Address - Fax:484-334-7026
Practice Address - Street 1:3200 READING CREST AVE
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-1656
Practice Address - Country:US
Practice Address - Phone:610-921-2366
Practice Address - Fax:610-929-5138
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029513E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA110242158OtherUNITED HEALTHCARE
PA19807000OtherINDEPENDENCE BLUE CROSS
PA110242158OtherRAILROAD MEDICARE
PA50000681OtherCAPITAL BLUE CROSS
PA50000681OtherCAPITAL BLUE CROSS
PAB96873Medicare UPIN