Provider Demographics
NPI:1972968840
Name:HASSAN, HANI OSMAN
Entity Type:Individual
Prefix:MS
First Name:HANI
Middle Name:OSMAN
Last Name:HASSAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HANI
Other - Middle Name:FAKI
Other - Last Name:DAHIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2312 1ST AVE S
Mailing Address - Street 2:207
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-3454
Mailing Address - Country:US
Mailing Address - Phone:612-886-5904
Mailing Address - Fax:612-354-3719
Practice Address - Street 1:1609 HOOVER DR
Practice Address - Street 2:12
Practice Address - City:NORTH MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56003-2665
Practice Address - Country:US
Practice Address - Phone:612-886-5904
Practice Address - Fax:612-354-3719
Is Sole Proprietor?:No
Enumeration Date:2015-12-21
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver