Healthcare Provider Details

I. General information

NPI: 1962921098
Provider Name (Legal Business Name): HANNAH HUAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2017
Last Update Date: 07/19/2023
Certification Date: 07/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 E PALISADE AVE
ENGLEWOOD CLIFFS NJ
07632-3058
US

IV. Provider business mailing address

625 CHESTNUT ST
TOWNSHIP OF WASHINGTON NJ
07676-4335
US

V. Phone/Fax

Practice location:
  • Phone: 201-820-5280
  • Fax:
Mailing address:
  • Phone: 201-961-3432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00512600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: