Healthcare Provider Details

I. General information

NPI: 1629891197
Provider Name (Legal Business Name): HANNAH HASSINGER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2024
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 CHAPEL AVE W
CHERRY HILL NJ
08002-2048
US

IV. Provider business mailing address

18 DARBY LN
CHERRY HILL NJ
08002-1603
US

V. Phone/Fax

Practice location:
  • Phone: 856-488-6500
  • Fax:
Mailing address:
  • Phone: 856-905-1759
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00890900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: