Provider Demographics
NPI:1780120238
Name:DIN, HIFZA R (PA)
Entity type:Individual
Prefix:MISS
First Name:HIFZA
Middle Name:R
Last Name:DIN
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:1902 81ST ST
Mailing Address - Street 2:APT 2G
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-1846
Mailing Address - Country:US
Mailing Address - Phone:347-658-4039
Mailing Address - Fax:
Practice Address - Street 1:7801 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-7439
Practice Address - Country:US
Practice Address - Phone:718-386-8300
Practice Address - Fax:718-386-0437
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY020504-1363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical