Healthcare Provider Details

I. General information

NPI: 1710809694
Provider Name (Legal Business Name): HARED I HASSAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 TALL PINES DR APT 8
LEWISTON ME
04240-3279
US

IV. Provider business mailing address

38 TALL PINES DR APT 8
LEWISTON ME
04240-3279
US

V. Phone/Fax

Practice location:
  • Phone: 207-344-8697
  • Fax: 207-344-8697
Mailing address:
  • Phone: 207-344-8697
  • Fax: 207-344-8697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: