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NPI Code Detail

MEDICARE: DR. HASSAN MANA HASSAN

MEDICARE: DR. HASSAN MANA HASSAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist03328872OH

General Provider Information

NPI Number : 1083907604
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HASSAN MANA HASSAN
Provider Business Mailing Address
First Line : 12521 TRISKETT RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-2526
Country : US
Telephone Number : 716-316-5540
Fax Number :
Provider Business Practice Location Address
First Line : 15149 SNOW RD
Second Line :
City : BROOK PARK
State : OH
Zip : 44142-2458
Country : US
Telephone Number : 216-676-5561
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2011
Last Update Date : 05/16/2011

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Directions to “ DR. HASSAN MANA HASSAN ” Practice Location

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