Hisham Assem, MD | NPI 1760047500

Key facts

NPI: 1760047500
Entity type: Individual (NPI type 1)
Primary specialty: Student in an Organized Health Care Education/Training Program 390200000X
Practice address: 20 York Street
Ynhh Tompkins 226
New Haven, CT 06510-3220
Phone: (203) 688-9503
Fax: (203) 688-5599
NPI assigned: May 7, 2019
Reactivated: Jan 24, 2020
Sex: Male
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Student in an Organized Health Care Education/Training Program	390200000X			Yes

Addresses

Primary practice location

20 York Street
Ynhh Tompkins 226
New Haven, CT 06510-3220

Mailing address

20 York Street
Ynhh Tompkins 226
New Haven, CT 06510-3220
Phone (203) 688-9503

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 24, 2020.

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1760047500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK STREET",
            "address_2": "YNHH TOMPKINS 226",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-9503",
            "fax_number": "203-688-5599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK STREET",
            "address_2": "YNHH TOMPKINS 226",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-9503",
            "fax_number": "203-688-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASSEM",
        "first_name": "HISHAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-07",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "deactivation_date": "2019-12-16",
        "reactivation_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

All providers in New Haven, CT · Student in an Organized Health Care Education/Training Program in Connecticut

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2020. 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.

Verify at the official NPI Registry.