Individual ProviderIssam Farhan HalasaStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address43 New Scotland Avenue, Dept. Of Internal Medicine, Alb, Albany, NY 12208(518) 915-2025(518) 262-4000PECOS EnrollmentBased on the most recent information from CMS, provider Issam Farhan Halasa does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1326770959Provider TypeIndividualFull NameHalasa, Issam FarhanGenderMaleSole ProprietorNoEnumeration Date6/30/2022Last Updated6/30/2022Contact InformationPractice LocationPractice Address43 New Scotland Avenue, Dept. Of Internal Medicine, Alb, Albany, NY 12208Phone(518) 915-2025FaxUnlisted FaxMailing LocationMailing Address43 New Scotland Avenue, Dept. Of Internal Medicine, Alb, Albany, NY 12208Phone(518) 262-4000FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted IssuerNew York