Provider Demographics
NPI:1285342519
Name:JASIM, HASAN
Entity type:Individual
Prefix:
First Name:HASAN
Middle Name:
Last Name:JASIM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 ELM ST
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-4409
Mailing Address - Country:US
Mailing Address - Phone:207-229-6047
Mailing Address - Fax:
Practice Address - Street 1:634 ELM ST
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-4409
Practice Address - Country:US
Practice Address - Phone:207-229-6047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME22222773610014251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health