Provider Demographics
NPI:1801360029
Name:HADDAD, GHASSAN GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:GHASSAN
Middle Name:GEORGE
Last Name:HADDAD
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 1:20 WATERSIDE PLZ APT 26E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-2665
Mailing Address - Country:US
Mailing Address - Phone:212-689-3417
Mailing Address - Fax:
Practice Address - Street 1:20 WATERSIDE PLZ APT 26E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-2665
Practice Address - Country:US
Practice Address - Phone:212-689-3417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0932342084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology