Healthcare Provider Details

I. General information

NPI: 1942406400
Provider Name (Legal Business Name): ILHAM ALQAISI & HARITH ALHASAN PHYSICIANS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 07/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 BEEBE ST
STATEN ISLAND NY
10301-4501
US

IV. Provider business mailing address

83 BEEBE ST
STATEN ISLAND NY
10301-4501
US

V. Phone/Fax

Practice location:
  • Phone: 718-556-0401
  • Fax:
Mailing address:
  • Phone: 718-556-0401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number159252
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number180760
License Number StateNY

VIII. Authorized Official

Name: HARITH ALHASAN
Title or Position: PART OWNER
Credential: MD
Phone: 718-556-0401