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General NPI Number Information
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NPI Number | 1730346156
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Entity Type | Individual
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Provider Name | HASSAN A TETTEH M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/22/2008
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Last Update Date | 09/28/2024
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Provider Practice Location Address
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Address Line | 8081 INNOVATION PARK DR STE 800
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City | FAIRFAX
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State | VA
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Zip | 22031-4867
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Country | US
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Telephone | 571-472-4600
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Fax | 571-665-6885
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Provider Business Mailing Address
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Address Line | 580 E 94TH ST
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City | BROOKLYN
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State | NY
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Zip | 11236-1104
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Country | US
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Telephone | 917-568-8400
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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 | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 217604
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 0101245216
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 217604
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License Number State | NY
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