Provider Demographics
NPI:1144058371
Name:HASSAN, HAMZA KHALIF
Entity type:Individual
Prefix:
First Name:HAMZA
Middle Name:KHALIF
Last Name:HASSAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:HAMZAHAJIMALLOW
Other - Middle Name:
Other - Last Name:ABDIRAKIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1920 4TH AVE S APT 805
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-2777
Mailing Address - Country:US
Mailing Address - Phone:612-226-4423
Mailing Address - Fax:
Practice Address - Street 1:3040 4TH AVE S UNIT 101
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2409
Practice Address - Country:US
Practice Address - Phone:612-226-4423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management