MEDICARE: MRS. CATARINA HANNA II

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	235Z00000X	Speech-Language Pathologist	016900-1	NY

General Provider Information

NPI Number	:	1700172079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CATARINA HANNA II

Provider Business Mailing Address
First Line	:	142 GOODEMOTE RD
Second Line	:
City	:	BROADALBIN
State	:	NY
Zip	:	12025-1756
Country	:	US
Telephone Number	:	518-883-5935
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 SCHOOL DISTRICT RD
Second Line	:	CANAJOHARIE ELEMENTARY SCHOOL
City	:	CANAJOHARIE
State	:	NY
Zip	:	13317-1542
Country	:	US
Telephone Number	:	581-673-6300
Fax Number	:

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

Provider Enumeration Date	:	06/24/2011
Last Update Date	:	06/24/2011

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