Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | MD23760 | ME |
NPI | 1003901430 |
---|---|
Provider Name | Dane Hassani |
First Address | Lewiston, ME 04243-7291 |
Second Address | Bangor, ME 04401-3979 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 03/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036116440 | (05) | IL |