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General NPI Number Information
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NPI Number | 1174722532
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Entity Type | Organization
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Legal Business Name | HANSON PLACE PHYSICIAN ASSOCIATES, P.C.
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Dates
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Enumeration Date | 07/16/2007
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Last Update Date | 07/16/2007
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Provider Practice Location Address
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Address Line | 55 GREENE AVE SUITE 2F
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City | BROOKLYN
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State | NY
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Zip | 11238-1026
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Country | US
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Telephone | 718-783-3690
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Fax | 718-783-5584
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Provider Business Mailing Address
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Address Line | 55 GREENE AVE SUITE 2F
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City | BROOKLYN
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State | NY
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Zip | 11238-1026
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Country | US
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Telephone | 718-783-3690
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Fax | 718-783-5584
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Authorized Official
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Title or Position | MD
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Name | JAHID AHAMED
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Credential |
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Telephone | 718-783-3690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 190011
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License Number State | NY
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