Provider Demographics
NPI:1043245392
Name:HASSAN, ASHRAF (DPT)
Entity type:Individual
Prefix:DR
First Name:ASHRAF
Middle Name:
Last Name:HASSAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 CRESTWATER CT
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-4300
Mailing Address - Country:US
Mailing Address - Phone:817-816-0143
Mailing Address - Fax:718-816-0413
Practice Address - Street 1:6919 4TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-1501
Practice Address - Country:US
Practice Address - Phone:718-745-2020
Practice Address - Fax:718-745-2022
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2017-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019429174400000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist