Provider Demographics
NPI:1215662515
Name:EJAZ, HASHIM (MBBS)
Entity type:Individual
Prefix:DR
First Name:HASHIM
Middle Name:
Last Name:EJAZ
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 FERNLEIGH DR APT B10
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-1323
Mailing Address - Country:US
Mailing Address - Phone:917-669-4243
Mailing Address - Fax:
Practice Address - Street 1:MARY IMOGENE BASSETT HOSPITAL
Practice Address - Street 2:1 ATWELL ROAD
Practice Address - City:COOPERSTOWN
Practice Address - State:NY
Practice Address - Zip Code:13326
Practice Address - Country:US
Practice Address - Phone:607-547-3456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-20
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty