Healthcare Provider Details

I. General information

NPI: 1154521714
Provider Name (Legal Business Name): HASSAN M HAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2007
Last Update Date: 07/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 UNIVERSITY DRIVE
HERSHEY PA
17033-0854
US

IV. Provider business mailing address

500 UNIVERSITY DRIVE
HERSHEY PA
17033-0854
US

V. Phone/Fax

Practice location:
  • Phone: 800-243-1455
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD428711
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierMD428711
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerMEDICAL LICENSE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: