Provider Demographics
NPI:1134170640
Name:HASAN, MUHAMMAD FAREED (MD)
Entity type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:FAREED
Last Name:HASAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2 THE DRAWBRIDGE
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-1000
Mailing Address - Country:US
Mailing Address - Phone:718-638-8185
Mailing Address - Fax:
Practice Address - Street 1:481 ST. MARKS AVE, BKLYN NY 11238, 718638-8185
Practice Address - Street 2:585 SCHENECTADY AVE
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-1809
Practice Address - Country:US
Practice Address - Phone:718-604-5401
Practice Address - Fax:718-604-5527
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY182626207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF42782Medicare UPIN