Provider Demographics
NPI:1093001117
Name:HASAN, NAZMUL (OD)
Entity type:Individual
Prefix:DR
First Name:NAZMUL
Middle Name:
Last Name:HASAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2106 BURLINGTON MOUNT HOLLY RD
Mailing Address - Street 2:WALMART VISION CENTER
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-4158
Mailing Address - Country:US
Mailing Address - Phone:732-331-8005
Mailing Address - Fax:
Practice Address - Street 1:2106 BURLINGTON MOUNT HOLLY RD
Practice Address - Street 2:WALMART VISION CENTER
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-4158
Practice Address - Country:US
Practice Address - Phone:732-331-8005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00631100152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist