Healthcare Provider Details

I. General information

NPI: 1952436867
Provider Name (Legal Business Name): RABBIA S HASSAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 DOUGHTY BLVD
INWOOD NY
11096
US

IV. Provider business mailing address

10 WEYANT DRIVE
CEDARHURST NY
11516
US

V. Phone/Fax

Practice location:
  • Phone: 516-850-3717
  • Fax:
Mailing address:
  • Phone: 516-792-5836
  • Fax: 516-239-1609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number132250
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: