Provider Demographics
NPI:1700174729
Name:HASSANAIN, EHAB AHMED (MD)
Entity Type:Individual
Prefix:DR
First Name:EHAB
Middle Name:AHMED
Last Name:HASSANAIN
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 1:393 SUNRISE HWY
Mailing Address - Street 2:SUITE 7
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-5909
Mailing Address - Country:US
Mailing Address - Phone:631-422-7200
Mailing Address - Fax:
Practice Address - Street 1:393 SUNRISE HWY
Practice Address - Street 2:SUITE 7
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-5909
Practice Address - Country:US
Practice Address - Phone:631-422-7200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-11
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY266145208D00000X
MI4301098874208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice