| S. Hasan Physician Pc | |
|
113 Church Ave Brooklyn NY 11218-3917 | |
| (718) 633-4677 | |
| (718) 633-3134 |
| Full Name | S. Hasan Physician Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 113 Church Ave, Brooklyn, New York |
| Authorized Official Name and Position | Shaikh N Hasan (PRESIDENT OF THE CORPORATION) |
| Authorized Official Contact | 9174988514 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| S. Hasan Physician Pc 14 Strawberry Ln Roslyn Heights NY 11577-2518 Ph: (917) 498-8514 | S. Hasan Physician Pc 113 Church Ave Brooklyn NY 11218-3917 Ph: (718) 633-4677 |
| NPI Number | 1104223569 |
|---|---|
| Provider Enumeration Date | 12/01/2014 |
| Last Update Date | 05/11/2015 |
| Medicare PECOS PAC ID | 3375577224 |
|---|---|
| Medicare Enrollment ID | O20150421001692 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104223569 | NPI | - | NPPES |
| 01919002 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 208519 (New York) | Primary |
| Provider Name | Shaikh N Hasan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225020860 PECOS PAC ID: 8729012679 Enrollment ID: I20051005001109 |
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