Individual
KHALED A. HASSAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1300 MAIN AVENUE, CLIFTON, NJ 07011
(973) 942-6900
Mailing address
71 HOOVER DRIVE, CRESSKILL, NJ 07626-1705
(201) 248-6080
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25MA06977000
NJ
207R00000X
Internal Medicine Physician
25MA06977000
NJ
207VG0400X
Gynecology Physician
Primary
25MA06977000
NJ
207VX0000X
Obstetrics Physician
25MA06977000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0082716
—
NJ
05
—
082716
—
NJ
Enumeration date
06/04/2006
Last updated
09/01/2009
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