MEDICARE: DR. DEBRA HANLEY MD

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
1	207RH0003X	Hematology & Oncology Physician	25MA04461000	NJ

General Provider Information

NPI Number	:	1659300069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBRA HANLEY MD

Provider Business Mailing Address
First Line	:	200 BOULEVARD
Second Line	:
City	:	HASBROUCK HEIGHTS
State	:	NJ
Zip	:	07604-1802
Country	:	US
Telephone Number	:	201-393-0911
Fax Number	:	201-393-0988

Provider Business Practice Location Address
First Line	:	1130 MCBRIDE AVE
Second Line	:
City	:	WEST PATERSON
State	:	NJ
Zip	:	07424-3806
Country	:	US
Telephone Number	:	973-256-5557
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	07/08/2007

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