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General NPI Number Information
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NPI Number | 1255294104
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Entity Type | Individual
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Provider Name | MOAMEN HASSAN
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Gender | Male
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 8727 AVENUE D
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City | BROOKLYN
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State | NY
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Zip | 11236-1600
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Country | US
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Telephone | 718-924-2122
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Fax | 718-924-2123
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Provider Business Mailing Address
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Address Line | 139 SAINT JOHNS AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10305-3040
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Country | US
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Telephone | 917-795-6354
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 055200
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License Number State | NY
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