Provider Demographics
NPI:1396995437
Name:HASAN, FARHAD (MD)
Entity type:Individual
Prefix:DR
First Name:FARHAD
Middle Name:
Last Name:HASAN
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 1:1002 EMERYVILLE RD STE 2
Mailing Address - Street 2:
Mailing Address - City:MARS
Mailing Address - State:PA
Mailing Address - Zip Code:16046-4404
Mailing Address - Country:US
Mailing Address - Phone:412-485-0311
Mailing Address - Fax:724-754-0090
Practice Address - Street 1:1002 EMERYVILLE RD STE 2
Practice Address - Street 2:
Practice Address - City:MARS
Practice Address - State:PA
Practice Address - Zip Code:16046-4404
Practice Address - Country:US
Practice Address - Phone:412-485-0311
Practice Address - Fax:724-754-0090
Is Sole Proprietor?:No
Enumeration Date:2008-09-25
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD464127207RE0101X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03257265Medicaid
NY10712AMedicare PIN
NY70005AMedicare PIN
NY03257265Medicaid
NYJ400056655Medicare PIN