MEDICARE: MR. MOHARRAM M HASSAN

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	172A00000X	Driver	335504708	NY
2	347E00000X	Transportation Broker		NY
3	342000000X	Transportation Network Company	B03142	NY
4	344600000X	Taxi

General Provider Information

NPI Number	:	1710826516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MOHARRAM M HASSAN

Provider Business Mailing Address
First Line	:	201 FOSTER AVE APT D1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-2139
Country	:	US
Telephone Number	:	718-247-7277
Fax Number	:	718-499-2619

Provider Business Practice Location Address
First Line	:	201 FOSTER AVE APT D1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-2139
Country	:	US
Telephone Number	:	718-247-7277
Fax Number	:	718-499-2619

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

Provider Enumeration Date	:	03/26/2026
Last Update Date	:	04/21/2026

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