Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | LT000821 | PA |
Y | 208200000X | Surgeon | R78864 | AZ |
Y | 208600000X | Surgeon | R78864 | AZ |
NPI | 1548823321 |
---|---|
Provider Name | Hasan Al Harakeh |
First Address | Scottsdale, AZ 85259-5452 |
Second Address | Scottsdale, AZ 85259-5452 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2019 |
Last Update Date | 26/08/2021 |