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NPI Code Detail

MEDICARE: EDWARD JOSPEH HANNAN M.D.

MEDICARE: EDWARD JOSPEH HANNAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician160806NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255341152
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDWARD JOSPEH HANNAN M.D.
Provider Business Mailing Address
First Line : 2231 BURDETT AVE
Second Line : SUITE 130
City : TROY
State : NY
Zip : 12180-2447
Country : US
Telephone Number : 518-272-0171
Fax Number : 517-271-6580
Provider Business Practice Location Address
First Line : 2231 BURDETT AVE
Second Line : SUITE 130
City : TROY
State : NY
Zip : 12180-2447
Country : US
Telephone Number : 518-272-0171
Fax Number : 517-271-6580
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2006
Last Update Date : 05/12/2008

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Directions to “ EDWARD JOSPEH HANNAN M.D.” Practice Location

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