Provider Demographics
NPI:1740646595
Name:HAREED, HASAN
Entity type:Individual
Prefix:
First Name:HASAN
Middle Name:
Last Name:HAREED
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 1:2242 7TH ST W APT 102
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-3309
Mailing Address - Country:US
Mailing Address - Phone:612-282-9887
Mailing Address - Fax:
Practice Address - Street 1:2242 7TH ST W APT 102
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-3309
Practice Address - Country:US
Practice Address - Phone:612-282-9887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-10
Last Update Date:2016-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN81-1016252146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant