Healthcare Provider Details

I. General information

NPI: 1356501589
Provider Name (Legal Business Name): JAMES ERNEST HANSEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2008
Last Update Date: 07/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 PARK ST SMILOW CANCER HOSPITAL AT YALE-NEW HAVEN
NEW HAVEN CT
06519-1110
US

IV. Provider business mailing address

35 PARK ST SMILOW CANCER HOSPITAL AT YALE-NEW HAVEN
NEW HAVEN CT
06519-1110
US

V. Phone/Fax

Practice location:
  • Phone: 203-200-2100
  • Fax: 203-200-2001
Mailing address:
  • Phone: 203-200-2100
  • Fax: 203-200-2001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number050686
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: