Active NPI
Maya Hassoun
- Pharmacist
- Detroit, MI
National Provider Identifier
1972334589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302416634
- Practice address
- 6862 Michigan Ave
Detroit, MI 48210-2868 - Phone
- (313) 849-6110
- NPI assigned
- Aug 13, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302416634 | MI | Primary |
Addresses
Primary practice location
6862 Michigan Ave
Detroit, MI 48210-2868
Mailing address
7917 Chase Rd
Dearborn, MI 48126-1082
Phone (313) 844-4073
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302416634 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Woodward Detroit CVS, L.L.C. | Current | Accepting new patients |
Locations
6862 Michigan Ave
Detroit, MI 48210
Phone (313) 849-6110
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723507200000",
"number": "1972334589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7917 CHASE RD",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481261082",
"telephone_number": "313-844-4073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6862 MICHIGAN AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482102868",
"telephone_number": "313-849-6110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HASSOUN",
"first_name": "MAYA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-13",
"last_updated": "2024-08-13",
"certification_date": "2024-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302416634",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.