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General NPI Number Information
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NPI Number | 1508176355
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Entity Type | Organization
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Legal Business Name | LITTLE NECK MEDICAL CENTER, INC
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Dates
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Enumeration Date | 10/14/2010
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Last Update Date | 10/14/2010
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Provider Practice Location Address
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Address Line | 3500 VIRGINIA BEACH BLVD SUITE 100
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-4445
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Country | US
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Telephone | 757-831-5349
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Fax |
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Provider Business Mailing Address
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Address Line | 3500 VIRGINIA BEACH BLVD SUITE 100
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-4445
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Country | US
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Telephone | 757-831-5349
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | FAIQ HASAN
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Credential |
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Telephone | 757-831-5349
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101245150
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License Number State | VA
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