Provider Demographics
NPI:1972576403
Name:HASHIN, KIMBERLY ANN (MD)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:HASHIN
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 1:106 S CLAUDE A LORD BLVD
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-3637
Mailing Address - Country:US
Mailing Address - Phone:570-622-4209
Mailing Address - Fax:570-622-1386
Practice Address - Street 1:106 S CLAUDE A LORD BLVD
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-3637
Practice Address - Country:US
Practice Address - Phone:570-622-4209
Practice Address - Fax:570-622-1386
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD059382L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0000874629OtherBLUE SHIELD
PA020301000OtherFEDERAL BLACK LUNG
PA0998130OtherKEYSTONE SPECIALIST
PA116993900OtherFEDERAL EMPLOYEES COMP
PA110152624OtherRAILROAD MEDICARE PBA
PA50024032OtherKEYSTONE
PA50024032OtherCAPITAL BLUE CROSS
PA21498OtherGEISINGER HEALTH PLAN
PA0015843610002Medicaid
PA0015843610002Medicaid
PA110152624OtherRAILROAD MEDICARE PBA