Provider Demographics
NPI:1912014747
Name:HASSEN, AHMED S (MD)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:S
Last Name:HASSEN
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 1:500 E 77TH ST
Mailing Address - Street 2:APT 1619
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10162-0025
Mailing Address - Country:US
Mailing Address - Phone:917-403-2595
Mailing Address - Fax:207-621-4816
Practice Address - Street 1:1 VA CTR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-6719
Practice Address - Country:US
Practice Address - Phone:207-623-8411
Practice Address - Fax:207-621-4816
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY206269207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease