Provider Demographics
NPI:1811767023
Name:OCCMED CONNECT LLC
Entity type:Organization
Organization Name:OCCMED CONNECT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-438-6094
Mailing Address - Street 1:23455 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-1908
Mailing Address - Country:US
Mailing Address - Phone:734-447-5243
Mailing Address - Fax:734-333-8005
Practice Address - Street 1:31450 FORD RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-1820
Practice Address - Country:US
Practice Address - Phone:734-447-5243
Practice Address - Fax:734-333-8002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care