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General NPI Number Information
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NPI Number | 1326217084
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Entity Type | Individual
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Provider Name | MARY A HANER RN
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Gender | Female
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Dates
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Enumeration Date | 02/27/2008
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Last Update Date | 02/27/2008
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Provider Practice Location Address
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Address Line | 228 FOUR CORNERS RD
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City | ANCRAMDALE
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State | NY
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Zip | 12503-5050
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Country | US
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Telephone | 518-329-5649
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Fax | 518-329-5689
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Provider Business Mailing Address
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Address Line | 83 MAIDEN LN 9TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10038-4812
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Country | US
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Telephone | 212-780-2528
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Fax | 212-777-3771
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 259460
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License Number State | NY
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