Healthcare Provider Details

I. General information

NPI: 1699146514
Provider Name (Legal Business Name): HENRY HASSON MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2015
Last Update Date: 10/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2769 CONEY ISLAND AVE 3ERD FLOOR
BROOKLYN NY
11235-5061
US

IV. Provider business mailing address

2769 CONEY ISLAND AVE 3ERD FLOOR
BROOKLYN NY
11235-5061
US

V. Phone/Fax

Practice location:
  • Phone: 718-785-9828
  • Fax: 718-425-0964
Mailing address:
  • Phone: 718-785-9828
  • Fax: 718-425-0964

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2080P0008X
TaxonomyPediatric Neurodevelopmental Disabilities Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HENRY HASSON
Title or Position: OWNER
Credential: MD
Phone: 718-785-9828