Provider Demographics
NPI:1710162730
Name:RAZA HASSAN MD INC
Entity Type:Organization
Organization Name:RAZA HASSAN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAZA
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-789-4971
Mailing Address - Street 1:PO BOX 292
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02880-0292
Mailing Address - Country:US
Mailing Address - Phone:401-789-4971
Mailing Address - Fax:845-207-9378
Practice Address - Street 1:105 STONEWAY RD
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-3969
Practice Address - Country:US
Practice Address - Phone:401-789-4971
Practice Address - Fax:401-789-2957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI4546174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty