Provider Demographics
NPI:1972030757
Name:GHAZLE, HAMAD (EDD, RDMS)
Entity Type:Individual
Prefix:
First Name:HAMAD
Middle Name:
Last Name:GHAZLE
Suffix:
Gender:M
Credentials:EDD, RDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CHAMBER VALLEY ESTS
Mailing Address - Street 2:
Mailing Address - City:SPENCERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14559-9301
Mailing Address - Country:US
Mailing Address - Phone:585-260-0837
Mailing Address - Fax:
Practice Address - Street 1:7 CHAMBER VALLEY ESTATES
Practice Address - Street 2:
Practice Address - City:SPENCERPORT
Practice Address - State:NY
Practice Address - Zip Code:14559
Practice Address - Country:US
Practice Address - Phone:585-260-0837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY319152471S1302X, 2471V0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography