Individual
MOHAMAD ATA HASSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
637 MAGEE AVE, PHILADELPHIA, PA 19111-4715
(215) 607-0684
Mailing address
637 MAGEE AVE, PHILADELPHIA, PA 19111-4715
(215) 607-0684
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
08/04/2022
Last updated
08/04/2022
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