Provider Demographics
NPI:1851655823
Name:ABUHASNA, SUAD M
Entity Type:Individual
Prefix:MS
First Name:SUAD
Middle Name:M
Last Name:ABUHASNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 STAFFORD AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-2109
Mailing Address - Country:US
Mailing Address - Phone:646-468-2272
Mailing Address - Fax:
Practice Address - Street 1:3 GREENHILLS RD
Practice Address - Street 2:
Practice Address - City:S HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11746
Practice Address - Country:US
Practice Address - Phone:516-777-8777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY14735OtherSERVICE COORDINATOR