Provider Demographics
NPI:1639271919
Name:HAKKI, SHEREEN (PHD OD)
Entity Type:Individual
Prefix:DR
First Name:SHEREEN
Middle Name:
Last Name:HAKKI
Suffix:
Gender:F
Credentials:PHD OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 CHIPPEWA RIDGE
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002
Mailing Address - Country:US
Mailing Address - Phone:908-859-9050
Mailing Address - Fax:908-859-6186
Practice Address - Street 1:ROUTE 22 E & ROUTE 519
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865
Practice Address - Country:US
Practice Address - Phone:908-859-9050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ5409152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ60321Medicare UPIN
PA730253Medicare ID - Type Unspecified
PA60321Medicare UPIN
NJ026307Medicare ID - Type Unspecified