Healthcare Provider Details

I. General information

NPI: 1821035544
Provider Name (Legal Business Name): NORMA STEPHENS HANNIGAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 07/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 MADISON ST MEDICAL STAFF OFFICE, ROOM 1249
NEW YORK NY
10002-7537
US

IV. Provider business mailing address

920 HUDSON STREET APT 2D
HOBOKEN NJ
07030
US

V. Phone/Fax

Practice location:
  • Phone: 212-238-7614
  • Fax: 212-238-7009
Mailing address:
  • Phone: 201-988-6140
  • Fax: 212-238-7009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF330990
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: