MEDICARE: HATEM E ABOUHASSAN PT

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	174400000X	Specialist	022907	NY

General Provider Information

NPI Number	:	1700017282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HATEM E ABOUHASSAN PT

Provider Business Mailing Address
First Line	:	200 BAY 49TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-7202
Country	:	US
Telephone Number	:	718-926-8040
Fax Number	:	718-236-0207

Provider Business Practice Location Address
First Line	:	200 BAY 49TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-7202
Country	:	US
Telephone Number	:	718-926-8040
Fax Number	:	718-236-0207

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

Provider Enumeration Date	:	08/02/2009
Last Update Date	:	08/02/2009

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