MEDICARE: DR. STEPHANIE HAKIMIAN M.D

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	390200000X	Student in an Organized Health Care Education/Training Program	125071638	IL
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	MD468789	PA

General Provider Information

NPI Number	:	1487036927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHANIE HAKIMIAN M.D

Provider Business Mailing Address
First Line	:	2004 W STATE ST
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16101-1248
Country	:	US
Telephone Number	:	724-657-3224
Fax Number	:

Provider Business Practice Location Address
First Line	:	2004 W STATE ST
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16101-1248
Country	:	US
Telephone Number	:	561-340-9718
Fax Number	:

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

Provider Enumeration Date	:	06/21/2015
Last Update Date	:	09/22/2020

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