Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 243928 | NY |
Y | 208600000X | Surgeon | 243928 | NY |
N | 2086S0102X | Surgical Critical Care | 243928 | NY |
N | 2086S0127X | Trauma Surgeon | 243928 | NY |
NPI | 1194770065 |
---|---|
Provider Name | Moustafa A Hassan |
First Address | Syracuse, NY 13210-2306 |
Second Address | Syracuse, NY 13210-2306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2006 |
Last Update Date | 28/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009983735 | (05) | AL |
009983745 | (05) | AL |
02870955 | (05) | NY |
08973733 | (05) | MS |
17-00359 | UNITED HEALTH CARE (01) | AL |
272003500 | (05) | FL |
51526800 | BLUE CROSS (01) | AL |
51526801 | BLUE CROSS (01) | AL |
H50859 | (02) |