Provider Demographics
NPI:1922002765
Name:HASSMAN, MICHAEL A (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:HASSMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:175 CROSS KEYS RD
Mailing Address - Street 2:300A
Mailing Address - City:BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08009-9263
Mailing Address - Country:US
Mailing Address - Phone:856-767-0077
Mailing Address - Fax:856-767-6102
Practice Address - Street 1:175 CROSS KEYS RD
Practice Address - Street 2:300A
Practice Address - City:BERLIN
Practice Address - State:NJ
Practice Address - Zip Code:08009-9263
Practice Address - Country:US
Practice Address - Phone:856-767-0077
Practice Address - Fax:856-767-6102
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB63702207Q00000X, 207QA0000X, 207QG0300X, 207XS0117X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJMB63702OtherLICENSE
NJG61916Medicare UPIN
NJ014081Medicare ID - Type UnspecifiedMEDICARE