Healthcare Provider Details

I. General information

NPI: 1679486153
Provider Name (Legal Business Name): HANAN HABEB MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 BEACH 19TH ST
FAR ROCKAWAY NY
11691-4423
US

IV. Provider business mailing address

66 SUGAR MAPLE DR
ROSLYN NY
11576-3229
US

V. Phone/Fax

Practice location:
  • Phone: 718-869-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberP140666
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: