Provider Demographics
NPI:1710221189
Name:HAJJAR, NANCY M (RN BSN)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:M
Last Name:HAJJAR
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1157 74TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-2018
Mailing Address - Country:US
Mailing Address - Phone:718-680-0443
Mailing Address - Fax:
Practice Address - Street 1:1157 74TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-2018
Practice Address - Country:US
Practice Address - Phone:718-680-0443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-25
Last Update Date:2012-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY389830-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse