Healthcare Provider Details

I. General information

NPI: 1902477565
Provider Name (Legal Business Name): YUSUKE HASHIMOTO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2021
Last Update Date: 07/21/2022
Certification Date: 07/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NATIONAL CANCER CENTER HOSPITAL EAST 6-5-1 KASHIWANOHA, KASHIWA-SHI
KASHIWA CHIBA
277857
JP

IV. Provider business mailing address

3-10-16-3 HARAYAMA, AOBA-KU
SATAIAMA SAITAMA
3360931
JP

V. Phone/Fax

Practice location:
  • Phone: 47-133-1111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number428816
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: