MEDICARE: DR. KRISTEN M HANLEY M.D.

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
1	208000000X	Pediatrics Physician	MT185728	PA
2	208000000X	Pediatrics Physician	MD433602	PA

General Provider Information

NPI Number	:	1255535407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTEN M HANLEY M.D.

Provider Business Mailing Address
First Line	:	11279 PERRY HWY
Second Line	:	SUITE 450
City	:	WEXFORD
State	:	PA
Zip	:	15090-9381
Country	:	US
Telephone Number	:	724-933-1100
Fax Number	:	724-933-1160

Provider Business Practice Location Address
First Line	:	8791 BARNES LAKE RD
Second Line	:	SUITE 202
City	:	IRWIN
State	:	PA
Zip	:	15642-3176
Country	:	US
Telephone Number	:	724-864-6824
Fax Number	:	724-864-6837

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2007
Last Update Date	:	04/02/2010

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