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NPI Code Detail

MEDICARE: TINA HANNA

MEDICARE:   TINA  HANNA
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
1163W00000XRegistered Nurse519502NY

General Provider Information

NPI Number : 1710029590
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA HANNA
Provider Business Mailing Address
First Line : PO BOX 651
Second Line :
City : WADDINGTON
State : NY
Zip : 13694-0651
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1003 PARK ST
Second Line :
City : OGDENSBURG
State : NY
Zip : 13669-3911
Country : US
Telephone Number : 315-713-9090
Fax Number : 315-713-9330
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2007
Last Update Date : 04/20/2022

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Directions to “ TINA HANNA ” Practice Location

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