MEDICARE: MS. GERI W HASON RPA-C

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
1	363A00000X	Physician Assistant	004928	NY

General Provider Information

NPI Number	:	1518177906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GERI W HASON RPA-C

Provider Business Mailing Address
First Line	:	504 4TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11215-3007
Country	:	US
Telephone Number	:	212-263-9700
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 BROADWAY 2ND FL
Second Line	:	NYU LANGONE TRINITY CTR
City	:	NY
State	:	NY
Zip	:	10006-3007
Country	:	US
Telephone Number	:	212-263-9700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	04/14/2021

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