Basic Information
| Provider Information | |||||||||
| NPI: | 1740259746 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HASNI | ||||||||
| FirstName: | SYED | ||||||||
| MiddleName: | SHAYAN AHMED | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1925 PACIFIC AVE | ||||||||
| Address2: | |||||||||
| City: | ATLANTIC CITY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 084016713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6094418146 | ||||||||
| FaxNumber: | 6094418002 | ||||||||
| Practice Location | |||||||||
| Address1: | 1925 PACIFIC AVE | ||||||||
| Address2: | |||||||||
| City: | ATLANTIC CITY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 084016713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6094418146 | ||||||||
| FaxNumber: | 6094418002 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2006 | ||||||||
| LastUpdateDate: | 04/09/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 227125 | MA | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 043946 | CT | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 38625 | KY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 25MA08951700 | NJ | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 1740259746 | 01 | CT | CHN | OTHER | 227125 | 01 | CT | CONNECTICARE | OTHER | 010043946CT01 | 01 | CT | BCBS | OTHER | 581828 | 01 | CT | HMN | OTHER | 1740259746 | 01 | TRICARE | OTHER | 7998938 | 01 | CT | AETNA | OTHER | 1740259746 | 01 | CT | CIGNA | OTHER | 001439464 | 05 | CT | MEDICAID | P00463044 | 01 | RAILROAD | OTHER |