Healthcare Provider Details
I. General information
NPI: 1376384867
Provider Name (Legal Business Name): MR. WALED KHALED HASAN SR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/06/2024
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5884 CHEVIOT RD
CINCINNATI OH
45247-6205
US
IV. Provider business mailing address
5884 CHEVIOT RD
CINCINNATI OH
45247-6205
US
V. Phone/Fax
- Phone: 513-239-9666
- Fax:
- Phone: 513-239-9666
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041S0200X |
| Taxonomy | School Social Worker |
| License Number | SV925426 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | SV925426 |
| License Number State | OH |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | SV925426 |
| License Number State | OH |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NN1001X |
| Taxonomy | Nutrition Chiropractor |
| License Number | SV925426 |
| License Number State | OH |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NS0005X |
| Taxonomy | Sports Physician Chiropractor |
| License Number | SV925426 |
| License Number State | OH |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | SV925426 |
| License Number State | OH |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WF0300X |
| Taxonomy | Flight Registered Nurse |
| License Number | SV925426 |
| License Number State | OH |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WH0200X |
| Taxonomy | Home Health Registered Nurse |
| License Number | SV925426 |
| License Number State | OH |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WS0200X |
| Taxonomy | School Registered Nurse |
| License Number | SV925426 |
| License Number State | OH |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | SV925426 |
| License Number State | OH |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 364SF0001X |
| Taxonomy | Family Health Clinical Nurse Specialist |
| License Number | SV925426 |
| License Number State | OH |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 373H00000X |
| Taxonomy | Day Training/Habilitation Specialist |
| License Number | |
| License Number State | |
| # 13 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 364SL0600X |
| Taxonomy | Long-Term Care Clinical Nurse Specialist |
| License Number | SV925426 |
| License Number State | OH |
| # 14 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TH0100X |
| Taxonomy | Health Service Psychologist |
| License Number | SV925426 |
| License Number State | OH |
| # 15 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YS0200X |
| Taxonomy | School Counselor |
| License Number | SV925426 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
