MEDICARE: FATIMA INAYAH HASAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1053253096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FATIMA INAYAH HASAN

Provider Business Mailing Address
First Line	:	17 ROGERS PARK AVE APT 1
Second Line	:
City	:	BRIGHTON
State	:	MA
Zip	:	02135-3148
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	464 HILLSIDE AVE STE 202
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02494-1228
Country	:	US
Telephone Number	:	781-400-5305
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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Directions to “ FATIMA INAYAH HASAN ” Practice Location

Language	Start Address	Practice Location

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