Provider Demographics
NPI:1649027889
Name:HOSSEIN HADIAN MD LLC
Entity type:Organization
Organization Name:HOSSEIN HADIAN MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOSSEIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HADIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-248-9170
Mailing Address - Street 1:PO BOX 2001
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-4501
Mailing Address - Country:US
Mailing Address - Phone:315-449-0513
Mailing Address - Fax:
Practice Address - Street 1:300 MERIDIAN CENTRE BLVD STE 305
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-3984
Practice Address - Country:US
Practice Address - Phone:585-491-6130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOSSEIN HADIAN MD LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
DMERCOtherDMERC