Provider Demographics
NPI:1295171429
Name:HATCH, AYESHA NZERIBE (MD)
Entity type:Individual
Prefix:
First Name:AYESHA
Middle Name:NZERIBE
Last Name:HATCH
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:STONY BOOK MEDICINE
Mailing Address - Street 2:HSC19-030
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8191
Mailing Address - Country:US
Mailing Address - Phone:631-444-1791
Mailing Address - Fax:631-444-7689
Practice Address - Street 1:STONY BOOK MEDICINE
Practice Address - Street 2:HSC19-030
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8191
Practice Address - Country:US
Practice Address - Phone:631-444-1791
Practice Address - Fax:631-444-7689
Is Sole Proprietor?:No
Enumeration Date:2013-05-15
Last Update Date:2020-11-27
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Provider Licenses
StateLicense IDTaxonomies
DCMD0485092086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery