Provider Demographics
NPI:1730121120
Name:HAHM, SAE JOON (MD)
Entity Type:Individual
Prefix:
First Name:SAE
Middle Name:JOON
Last Name:HAHM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 RESEARCH DR STE 105
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-6228
Mailing Address - Country:US
Mailing Address - Phone:203-210-6340
Mailing Address - Fax:203-502-2615
Practice Address - Street 1:19 LAUREL AVE STE 102
Practice Address - Street 2:
Practice Address - City:CORNWALL
Practice Address - State:NY
Practice Address - Zip Code:12518-1403
Practice Address - Country:US
Practice Address - Phone:845-822-8100
Practice Address - Fax:845-822-8110
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0549312086S0129X
NY2622992086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03358174Medicaid
NYA400055162Medicare PIN
NY03358174Medicaid