Healthcare Provider Details

I. General information

NPI: 1578656765
Provider Name (Legal Business Name): KRISZTINA ZSDRAL HANLEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 01/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1364 CLIFTON RD NE
ATLANTA GA
30322-1064
US

IV. Provider business mailing address

1364 CLIFTON RD NE
ATLANTA GA
30322-1064
US

V. Phone/Fax

Practice location:
  • Phone: 404-712-2753
  • Fax:
Mailing address:
  • Phone: 404-712-2753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number058750
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: