Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 282585 | NY |
NPI | 1003226077 |
---|---|
Provider Name | Dr. Shorok E Hassan |
First Address | Staten Island, NY 10305-3436 |
Second Address | Staten Island, NY 10305 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2014 |
Last Update Date | 01/04/2020 |