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General NPI Number Information
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NPI Number | 1174990998
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Entity Type | Individual
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Provider Name | SNEHASHIS HAZRA MD
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Gender | Male
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Dates
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Enumeration Date | 08/27/2015
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Last Update Date | 04/25/2024
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Provider Practice Location Address
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Address Line | 3901 BEAUBIEN BLVD
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City | DETROIT
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State | MI
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Zip | 48201-4820
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Country | US
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Telephone | 646-617-8437
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Fax |
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Provider Business Mailing Address
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Address Line | 3800 WOODWARD AVE APT 601
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City | DETROIT
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State | MI
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Zip | 48201-2061
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Country | US
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Telephone | 646-617-8437
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 4301505071
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 25MA11756800
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License Number State | NJ
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