Provider Demographics
NPI:1891788188
Name:HASSAN, ZAMIR (MD)
Entity Type:Individual
Prefix:
First Name:ZAMIR
Middle Name:
Last Name:HASSAN
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 1:1401 S 31ST ST FL 2
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-3506
Mailing Address - Country:US
Mailing Address - Phone:215-925-2400
Mailing Address - Fax:215-925-9162
Practice Address - Street 1:1401 S 31ST STREET-2ND FLOOR
Practice Address - Street 2:930 WASHINGTON AVE
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146
Practice Address - Country:US
Practice Address - Phone:215-925-2400
Practice Address - Fax:215-925-9162
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD051350L207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA110078976OtherRR MEDICARE
PA0697808000OtherINDEPENDENCE BLUE CROSS
PA0145354804OtherAMERICHOICE
PA755661OtherHIGHMARK
PA09391OtherHEALTH PARTNERS
PA1024187OtherKEYSTONE MERCY
PA2566707OtherUNITED HEALTHCARE
PA001453548Medicaid
PA755661X9JMedicare PIN
PA110078976OtherRR MEDICARE
PA001453548Medicaid