Healthcare Provider Details

I. General information

NPI: 1710826516
Provider Name (Legal Business Name): MR. MOHARRAM M HASSAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 FOSTER AVE APT D1
BROOKLYN NY
11230-2139
US

IV. Provider business mailing address

201 FOSTER AVE APT D1
BROOKLYN NY
11230-2139
US

V. Phone/Fax

Practice location:
  • Phone: 718-247-7277
  • Fax: 718-499-2619
Mailing address:
  • Phone: 718-247-7277
  • Fax: 718-499-2619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number335504708
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License NumberB03142
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: