Hasan Haris Ahmad, MD
Individual provider Active NPI Pediatrics Physician · Queens Village, NY
NPI 1104017136 · NPPES record last updated Aug 10, 2007
Key facts
- NPI
- 1104017136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 186002 (NY)
- Practice address
- 8608 Range St
Queens Village, NY 11427-2722 - Phone
- (917) 373-8103
- NPI assigned
- Aug 6, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 186002 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Appalachian Regional Healthcare, Inc. | Past | Accepting new patients | |
| Appalachian Regional Healthcare, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 186002 | NY | Yes |
Addresses
Primary practice location
8608 Range St
Queens Village, NY 11427-2722
Mailing address
8608 Range St
Queens Village, NY 11427-2722
Phone (917) 373-8103
Other providers in Queens Village, NY
- Agape Vision Inc
- Irene Agbato
- Peace O Aghwana
- Ego Ahaneku
- Pauline S Aharon
- Moeed Ahmad
- Ahbab Ahmed
- Jafreen Ahmed
- Jamil Ahsan
- Mohammad Sharukh Ahsan
All providers in Queens Village, NY · Pediatrics Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.