Healthcare Provider Details

I. General information

NPI: 1407152150
Provider Name (Legal Business Name): HENRY HASSON M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2011
Last Update Date: 01/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

2769 CONEY ISLAND AVE 3RD 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 TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number240365
License Number StateNY

VIII. Authorized Official

Name: DR. HENRY HASSON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 718-785-9828