MEDICARE: ARCADIA FAMILY PRACTICE

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	363LF0000X	Family Nurse Practitioner	338683	NY

General Provider Information

NPI Number	:	1760802706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARCADIA FAMILY PRACTICE

Provider Business Mailing Address
First Line	:	3669 COUNTRYSIDE LN
Second Line	:	PO BOX 110
City	:	MARION
State	:	NY
Zip	:	14505-9781
Country	:	US
Telephone Number	:	315-926-7733
Fax Number	:

Provider Business Practice Location Address
First Line	:	3669 COUNTRYSIDE LN
Second Line	:
City	:	MARION
State	:	NY
Zip	:	14505-9781
Country	:	US
Telephone Number	:	315-926-7733
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. DAVID HANNAN
Credential	:	MD
Telephone Number	:	315-926-7733

Provider Enumeration Date	:	04/17/2014
Last Update Date	:	04/17/2014

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1184640138 — DAVID THOMAS HANNAN MD
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14505-9781

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1255491387 — ARCADIA FAMILY PRACTICE, P.C.
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1548473770 — DR. PHILIP S. NASH DDS
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Directions to “ARCADIA FAMILY PRACTICE ” Practice Location

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