Healthcare Provider Details

I. General information

NPI: 1598181984
Provider Name (Legal Business Name): PATIMA HASHIMI PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2014
Last Update Date: 03/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 55TH ST STATION 3-03
BROOKLYN NY
11220-2508
US

IV. Provider business mailing address

19 DOSORIS WAY
GLEN COVE NY
11542-2602
US

V. Phone/Fax

Practice location:
  • Phone: 718-630-6808
  • Fax: 718-630-8894
Mailing address:
  • Phone: 516-724-4377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number017287
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: