Provider Demographics
NPI:1427491265
Name:HAZAN, ALBERT (MD)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:
Last Name:HAZAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 W 165TH ST
Mailing Address - Street 2:HARKNESS EYE INSTITUTE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3724
Mailing Address - Country:US
Mailing Address - Phone:212-342-1190
Mailing Address - Fax:
Practice Address - Street 1:2148 OCEAN AVE STE 603
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229
Practice Address - Country:US
Practice Address - Phone:718-339-5100
Practice Address - Fax:718-339-2648
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-11
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY289135207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty