Healthcare Provider Details

I. General information

NPI: 1780515569
Provider Name (Legal Business Name): AHMED HASSAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7307 153RD ST APT 3B
FLUSHING NY
11367-3011
US

IV. Provider business mailing address

7307 153RD ST APT 3B
FLUSHING NY
11367-3011
US

V. Phone/Fax

Practice location:
  • Phone: 929-636-7500
  • Fax:
Mailing address:
  • Phone: 929-636-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number60-P142369-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: