=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962921098
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HANNAH HUAN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/09/2017
-----------------------------------------------------
Last Update Date | 07/19/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 700 E PALISADE AVE
-----------------------------------------------------
City | ENGLEWOOD CLIFFS
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07632-3058
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-820-5280
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 625 CHESTNUT ST
-----------------------------------------------------
City | TOWNSHIP OF WASHINGTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07676-4335
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-961-3432
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | 25MP00512600
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------