1003006636 NPI number — SABA F HASAN MD

Table of content: SABA F HASAN MD (NPI 1003006636)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003006636 NPI number — SABA F HASAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HASAN
Provider First Name:
SABA
Provider Middle Name:
F
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003006636
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/07/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5544 GREENWICH RD STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VIRGINIA BEACH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23462-6563
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-466-0089
Provider Business Mailing Address Fax Number:
757-466-8017

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5544 GREENWICH RD STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VIRGINIA BEACH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23462-6563
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-466-0089
Provider Business Practice Location Address Fax Number:
757-466-8017
Provider Enumeration Date:
07/30/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  0101244877 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10055347 . This is a "SENTARA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: P00813542 . This is a "RR MEDICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 10055347 . This is a "OPTIMA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 139178 . This is a "BCBS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1067351 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5914262 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".