Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 196471 | NY |
NPI | 1124048590 |
---|---|
Provider Name | Dr. Noreen Hasan |
First Address | Jonesboro, AR 72401-3120 |
Second Address | Jonesboro, AR 72401-3120 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 15/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
191916001 | (05) | AR |
5AJ59 | (02) | AR |
G15821 | (02) | NY |