Basic Information
Provider Information
NPI: 1508283417
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HASSEN
FirstName: LAUREN
MiddleName: JOANN
NamePrefix:  
NameSuffix:  
Credential: MD, MPH
OtherOrganizationName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 700 ACKERMAN RD STE 2120
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432021559
CountryCode: US
TelephoneNumber: 6142937677
FaxNumber:  
Practice Location
Address1: 410 W 10TH AVE
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432101240
CountryCode: US
TelephoneNumber: 6142937677
FaxNumber: 6142935614
Other Information
ProviderEnumerationDate: 03/28/2014
LastUpdateDate: 07/06/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/06/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X35.127521OHY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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