Healthcare Provider Details

I. General information

NPI: 1861550857
Provider Name (Legal Business Name): JENNIFER HASHEM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 PARKSIDE AVE
BROOKLYN NY
11226-1786
US

IV. Provider business mailing address

760 PARKSIDE AVE
BROOKLYN NY
11226-1786
US

V. Phone/Fax

Practice location:
  • Phone: 718-906-6590
  • Fax:
Mailing address:
  • Phone: 201-549-8860
  • Fax: 201-549-8861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number051638
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number295579
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: