Provider Demographics
NPI:1013760610
Name:ITANI, HADI (MD)
Entity Type:Individual
Prefix:MR
First Name:HADI
Middle Name:
Last Name:ITANI
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 1:675 SEAVIEW AVE
Mailing Address - Street 2:STATEN ISLAND UNIVERSITY HOSPITAL DEPARTMENT OF MEDICIN
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305
Mailing Address - Country:US
Mailing Address - Phone:718-226-6993
Mailing Address - Fax:
Practice Address - Street 1:675 SEAVIEW AVE
Practice Address - Street 2:STATEN ISLAND UNIVERSITY HOSPITAL DEPARTMENT OF MEDICIN
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305
Practice Address - Country:US
Practice Address - Phone:718-226-6993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program