Provider Demographics
NPI:1851100820
Name:KULIEV, HASAN (DDS)
Entity type:Individual
Prefix:
First Name:HASAN
Middle Name:
Last Name:KULIEV
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 BROADWAY
Mailing Address - Street 2:DEPARTMENT OF DENTISTRY & OMS, SUITE 2C-319
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206
Mailing Address - Country:US
Mailing Address - Phone:718-963-8308
Mailing Address - Fax:718-963-8317
Practice Address - Street 1:760 BROADWAY
Practice Address - Street 2:DEPARTMENT OF DENTISTRY & OMS, SUITE 2C-319
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206
Practice Address - Country:US
Practice Address - Phone:718-963-8308
Practice Address - Fax:718-963-8317
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-04
Last Update Date:2025-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program