Provider Demographics
NPI:1649500604
Name:NASSEF. F. HASSAN, PHYSICIAN, PC
Entity type:Organization
Organization Name:NASSEF. F. HASSAN, PHYSICIAN, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D
Authorized Official - Prefix:
Authorized Official - First Name:NASSEF
Authorized Official - Middle Name:FARAHAT
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-491-4002
Mailing Address - Street 1:6810 5TH AVENUE
Mailing Address - Street 2:NASSEF F. HASSAN
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220
Mailing Address - Country:US
Mailing Address - Phone:718-491-4002
Mailing Address - Fax:718-491-4030
Practice Address - Street 1:6810 5TH AVE
Practice Address - Street 2:NASSEF F. HASSAN
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220
Practice Address - Country:US
Practice Address - Phone:718-491-4002
Practice Address - Fax:718-491-4030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-13
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY206779261QP3300X, 261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1902867807OtherNPI
NY01854140Medicaid
NYG70935Medicare UPIN
NY01854140Medicaid