Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 0101267727 | VA |
N | 207Q00000X | Family Doctor | MT212194 | PA |
NPI | 1003267543 |
---|---|
Provider Name | Roza H Hassen |
First Address | Arlington, VA 22201-5758 |
Second Address | Arlington, VA 22201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2016 |
Last Update Date | 15/10/2020 |