Provider Demographics
NPI:1528704632
Name:HASSAN, MOHAMED (RPH)
Entity type:Individual
Prefix:
First Name:MOHAMED
Middle Name:
Last Name:HASSAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 MALL RD
Mailing Address - Street 2:6 CENTRAL, GASTROENTEROLOGY, IBD CENTER
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01805-0001
Mailing Address - Country:US
Mailing Address - Phone:781-744-8740
Mailing Address - Fax:603-777-1891
Practice Address - Street 1:41 MALL RD
Practice Address - Street 2:6 CENTRAL, GASTROENTEROLOGY, IBD CENTER
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01805-0001
Practice Address - Country:US
Practice Address - Phone:781-744-8740
Practice Address - Fax:603-777-1891
Is Sole Proprietor?:No
Enumeration Date:2022-05-11
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH240756183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist