1477301927 NPI number — MR. HAZEM KHALIL ISMAIL DAHSHAN

Table of content: MR. HAZEM KHALIL ISMAIL DAHSHAN (NPI 1477301927)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477301927 NPI number — MR. HAZEM KHALIL ISMAIL DAHSHAN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DAHSHAN
Provider First Name:
HAZEM
Provider Middle Name:
KHALIL ISMAIL
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
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:
1477301927
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/02/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1140 ASH STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DANVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17821
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ISMAILIA THIRD DISTRICT EGYPT
Provider Second Line Business Practice Location Address:
EL ZOHOUR DISTRICT EL DAWAGEN TOWER APT 205
Provider Business Practice Location Address City Name:
ISMAILIA
Provider Business Practice Location Address State Name:
ISMAILIA
Provider Business Practice Location Address Postal Code:
41511
Provider Business Practice Location Address Country Code:
EG
Provider Business Practice Location Address Telephone Number:
201-002-8209
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/09/2024

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: 207L00000X , with the licence number:  MT230596 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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