Provider Demographics
NPI:1174897953
Name:HASSAN, ABDULLAHI JAMA SR
Entity type:Individual
Prefix:MRS
First Name:ABDULLAHI
Middle Name:JAMA
Last Name:HASSAN
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6161 BUSCH BLVD STE 80
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-2548
Mailing Address - Country:US
Mailing Address - Phone:614-340-2040
Mailing Address - Fax:614-947-1382
Practice Address - Street 1:6161 BUSCH BLVD SUITE 80
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-2548
Practice Address - Country:US
Practice Address - Phone:614-340-2040
Practice Address - Fax:614-947-1382
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health