Basic Information
| Provider Information | |||||||||
| NPI: | 1003267543 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HASSEN | ||||||||
| FirstName: | ROZA | ||||||||
| MiddleName: | H | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1005 N GLEBE RD STE 160 | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 222015758 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5714923045 | ||||||||
| FaxNumber: | 5714923046 | ||||||||
| Practice Location | |||||||||
| Address1: | 1005 N GLEBE RD STE 160 | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 22201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5714923045 | ||||||||
| FaxNumber: | 5714923046 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2016 | ||||||||
| LastUpdateDate: | 10/15/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MT212194 | PA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 0101267727 | VA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.