Individual
DR. HANY NAGY YASSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
405 W COUNTRY CLUB RD, ROSWELL, NM 88201-5209
(505) 622-8170
(505) 624-8726
Mailing address
PO BOX 1029, ROSWELL, NM 88202-1029
(505) 637-7430
(505) 637-7474
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2002-0386
NM
207R00000X
Internal Medicine Physician
C53263
CA
208M00000X
Hospitalist Physician
Primary
C53263
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
97306754
—
NM
01
—
NM007E65
BCBS
NM
Enumeration date
09/21/2005
Last updated
07/31/2024
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