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General NPI Number Information
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NPI Number | 1245922517
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Entity Type | Individual
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Provider Name | DAVID MARK HANS SR.
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Gender | Male
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Dates
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Enumeration Date | 05/24/2023
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 342 HARBOURTOWN BLVD
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City | LITTLE EGG HARBOR TWP
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State | NJ
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Zip | 08087-3314
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Country | US
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Telephone | 856-264-6165
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Fax | 609-296-7929
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Provider Business Mailing Address
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Address Line | 342 HARBOURTOWN BLVD
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City | LITTLE EGG HARBOR TWP
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State | NJ
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Zip | 08087-3314
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Country | US
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Telephone | 856-264-6165
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Fax | 609-296-7929
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 31TD00397900
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License Number State | NJ
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