Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 35096697 | OH |
NPI | 1023253077 |
---|---|
Provider Name | Deena M Hassuna |
First Address | Gallipolis, OH 45631-1560 |
Second Address | Gallipolis, OH 45631-1560 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2008 |
Last Update Date | 21/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3145939 | (05) | OH |
3810027612 | (05) | WV |