Healthcare Provider Details

I. General information

NPI: 1548765027
Provider Name (Legal Business Name): NEREEN HASSAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2018
Last Update Date: 07/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7425 ARLINGTON RD
BETHESDA MD
20814
US

IV. Provider business mailing address

137 LINCOLN AVE
WEST MILFORD NJ
07480-2134
US

V. Phone/Fax

Practice location:
  • Phone: 301-652-2123
  • Fax:
Mailing address:
  • Phone: 973-800-2571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN1001970
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number16749
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: