Provider Demographics
NPI:1700988334
Name:HASAN, SABA (MD)
Entity Type:Individual
Prefix:
First Name:SABA
Middle Name:
Last Name:HASAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3131 PRINCETON PIKE
Mailing Address - Street 2:BUILDING 5, SUITE 208
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2201
Mailing Address - Country:US
Mailing Address - Phone:609-815-7810
Mailing Address - Fax:609-815-7894
Practice Address - Street 1:446 BELLEVUE AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-4502
Practice Address - Country:US
Practice Address - Phone:609-394-4000
Practice Address - Fax:609-815-7099
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06941500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8298203Medicaid
NJ041748M5NMedicare PIN
NJ8298203Medicaid