Healthcare Provider Details

I. General information

NPI: 1962105585
Provider Name (Legal Business Name): MUHAMMAD HASSAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2023
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 LANSDOWNE AVE
DARBY PA
19023-1200
US

IV. Provider business mailing address

169 RIVERSIDE DR
BINGHAMTON NY
13905-4246
US

V. Phone/Fax

Practice location:
  • Phone: 610-237-4000
  • Fax:
Mailing address:
  • Phone: 607-798-5111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD493128
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: