Provider Demographics
NPI:1548869928
Name:AWAN, HASAN ADNAN (DC)
Entity type:Individual
Prefix:DR
First Name:HASAN
Middle Name:ADNAN
Last Name:AWAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 IVES ST UNIT 311
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-2238
Mailing Address - Country:US
Mailing Address - Phone:203-809-4133
Mailing Address - Fax:
Practice Address - Street 1:200 QUEEN ST
Practice Address - Street 2:
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-1901
Practice Address - Country:US
Practice Address - Phone:860-621-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-18
Last Update Date:2020-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002197111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor