MEDICARE: HASAN A DHOONDIA

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	310400000X	Assisted Living Facility		WI

General Provider Information

NPI Number	:	1750277018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HASAN A DHOONDIA

Provider Business Mailing Address
First Line	:	1294 CHESTERWOOD LN
Second Line	:
City	:	PEWAUKEE
State	:	WI
Zip	:	53072-6308
Country	:	US
Telephone Number	:	414-309-6688
Fax Number	:

Provider Business Practice Location Address
First Line	:	2109 W MCKINLEY AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53205-2431
Country	:	US
Telephone Number	:	414-309-6688
Fax Number	:

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

Provider Enumeration Date	:	06/14/2025
Last Update Date	:	06/14/2025

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Directions to “ HASAN A DHOONDIA ” Practice Location

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