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NPI Code Detail

MEDICARE: MARY C HANEY NP

MEDICARE: MARY C HANEY NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner334029NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083670293
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY C HANEY NP
Provider Business Mailing Address
First Line : 908 NIAGARA FALLS BLVD
Second Line : SUITE 208
City : NORTH TONAWANDA
State : NY
Zip : 14120-2019
Country : US
Telephone Number : 716-692-3302
Fax Number : 716-692-4342
Provider Business Practice Location Address
First Line : 2931 MILITARY RD
Second Line :
City : NIAGARA FALLS
State : NY
Zip : 14304-1251
Country : US
Telephone Number : 716-298-4869
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2006
Last Update Date : 11/10/2011

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Directions to “ MARY C HANEY NP” Practice Location

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