1174897953 NPI number — MRS. ABDULLAHI JAMA HASSAN SR.

Table of content: MRS. ABDULLAHI JAMA HASSAN SR. (NPI 1174897953)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174897953 NPI number — MRS. ABDULLAHI JAMA HASSAN SR.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HASSAN
Provider First Name:
ABDULLAHI
Provider Middle Name:
JAMA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
SR.
Provider Credential Text:
Provider Gender Code:
M

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:
1174897953
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6161 BUSCH BLVD STE 80
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43229-2548
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-340-2040
Provider Business Mailing Address Fax Number:
614-947-1382

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6161 BUSCH BLVD SUITE 80
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43229-2548
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-340-2040
Provider Business Practice Location Address Fax Number:
614-947-1382
Provider Enumeration Date:
02/27/2012

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: 251E00000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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