MEDICARE: MICHAEL HANAN 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	208000000X	Pediatrics Physician	233117	NY

General Provider Information

NPI Number	:	1780648071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL HANAN MD

Provider Business Mailing Address
First Line	:	10325 68TH AVE
Second Line	:	APT 3-0
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-3267
Country	:	US
Telephone Number	:	718-975-0701
Fax Number	:	718-975-0703

Provider Business Practice Location Address
First Line	:	2401 AVENUE X
Second Line	:	1ST FLOOR. MICHAEL HANAN MEDICAL P.C.
City	:	BROOKLYN
State	:	NY
Zip	:	11235-2516
Country	:	US
Telephone Number	:	718-975-0701
Fax Number	:	718-975-0703

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

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	02/20/2014

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