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General NPI Number Information
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NPI Number | 1275343147
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Entity Type | Individual
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Provider Name | MD ABU HASAN
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Gender | Male
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Dates
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Enumeration Date | 01/13/2025
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 8725 MYRTLE AVE
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City | GLENDALE
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State | NY
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Zip | 11385-7847
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Country | US
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Telephone | 718-928-3290
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Fax |
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Provider Business Mailing Address
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Address Line | 10957 77TH ST
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City | OZONE PARK
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State | NY
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Zip | 11417-1146
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Country | US
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Telephone | 929-271-8174
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 033713
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License Number State | NY
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