Provider Demographics
NPI:1649875634
Name:HASSEN, RONALD R
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:R
Last Name:HASSEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 FIFTH STREET
Mailing Address - Street 2:
Mailing Address - City:ELLWOOD CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16117
Mailing Address - Country:US
Mailing Address - Phone:724-752-2588
Mailing Address - Fax:724-752-0103
Practice Address - Street 1:120 FIFTH STREET
Practice Address - Street 2:
Practice Address - City:ELLWOOD CITY
Practice Address - State:PA
Practice Address - Zip Code:16117
Practice Address - Country:US
Practice Address - Phone:724-752-2588
Practice Address - Fax:724-752-0103
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP033253R183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist