Provider Demographics
NPI:1023053980
Name:ABBASS, HASSAN (MD)
Entity type:Individual
Prefix:DR
First Name:HASSAN
Middle Name:
Last Name:ABBASS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 74550
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44194-0002
Mailing Address - Country:US
Mailing Address - Phone:216-383-6776
Mailing Address - Fax:216-383-6745
Practice Address - Street 1:5850 LANDERBROOK DR STE 100
Practice Address - Street 2:
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124-4071
Practice Address - Country:US
Practice Address - Phone:216-488-4800
Practice Address - Fax:440-786-1321
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-068071207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2052059Medicaid
OHG78324Medicare UPIN
OH0855287Medicare ID - Type Unspecified