Basic Information
| Provider Information | |||||||||
| NPI: | 1528292711 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUSSEINZADEH | ||||||||
| FirstName: | HOLLEH | ||||||||
| MiddleName: | DARIA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1015 CHESTNUT ST STE 1321 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191074313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159554730 | ||||||||
| FaxNumber: | 2155039188 | ||||||||
| Practice Location | |||||||||
| Address1: | 1015 CHESTNUT ST STE 1321 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191074313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159554730 | ||||||||
| FaxNumber: | 2155039188 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2009 | ||||||||
| LastUpdateDate: | 10/27/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0000X | 57.016572 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology | 207RH0003X | MD457412 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.