Provider Demographics
NPI:1699071225
Name:HASSAN, AZHAR JABIR (MD)
Entity type:Individual
Prefix:DR
First Name:AZHAR
Middle Name:JABIR
Last Name:HASSAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 SCHENECTADY AVE
Mailing Address - Street 2:APT 2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-1821
Mailing Address - Country:US
Mailing Address - Phone:585-313-7025
Mailing Address - Fax:
Practice Address - Street 1:608 SCHENECTADY AVE
Practice Address - Street 2:APT 2
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-1821
Practice Address - Country:US
Practice Address - Phone:585-313-7025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-29
Last Update Date:2011-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program