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General NPI Number Information
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NPI Number | 1780648071
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Entity Type | Individual
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Provider Name | MICHAEL HANAN MD
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Gender | Male
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 02/20/2014
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Provider Practice Location Address
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Address Line | 2401 AVENUE X 1ST FLOOR. MICHAEL HANAN MEDICAL P.C.
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City | BROOKLYN
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State | NY
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Zip | 11235-2516
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Country | US
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Telephone | 718-975-0701
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Fax | 718-975-0703
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Provider Business Mailing Address
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Address Line | 10325 68TH AVE APT 3-0
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City | FOREST HILLS
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State | NY
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Zip | 11375-3267
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Country | US
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Telephone | 718-975-0701
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Fax | 718-975-0703
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 233117
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License Number State | NY
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