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Individual

DR. MARC B HAZAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 W CARVER STREET, SUITE 1, HUNTINGTON, NY 11743
(631) 421-0020
(631) 421-5991
Mailing address
200 W CARVER STREET, SUITE 1, HUNTINGTON, NY 11743
(631) 421-0020
(631) 421-5991

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
134494
NY
207RC0000X
Cardiovascular Disease Physician
Primary
134494
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110052703
RAILROAD MEDICARE
05
W91571
NY
Enumeration date
08/31/2006
Last updated
03/24/2008
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