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General NPI Number Information
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NPI Number | 1174653513
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Entity Type | Organization
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Legal Business Name | NEZIH Z. HASANOGLU, D.O., S.C.
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 13700 W NATIONAL AVE SUITE 116
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City | NEW BERLIN
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State | WI
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Zip | 53151-9521
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Country | US
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Telephone | 262-782-5662
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Fax | 262-782-5296
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Provider Business Mailing Address
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Address Line | 13700 W NATIONAL AVE SUITE 116
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City | NEW BERLIN
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State | WI
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Zip | 53151-9521
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Country | US
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Telephone | 262-782-5662
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Fax | 262-782-5296
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NEZIH Z. HASANOGLU
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Credential | D.O.
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Telephone | 262-782-5662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25286
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License Number State | WI
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