MEDICARE: HANSEN A YUAN 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	207XS0117X	Orthopaedic Surgery of the Spine Physician	118107	NY
2	207X00000X	Orthopaedic Surgery Physician	118107	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992797013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANSEN A YUAN MD

Provider Business Mailing Address
First Line	:	550 HARRISON ST
Second Line	:	STE 130
City	:	SYRACUSE
State	:	NY
Zip	:	13202-3064
Country	:	US
Telephone Number	:	315-464-4472
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 HARRISON ST
Second Line	:	STE 130
City	:	SYRACUSE
State	:	NY
Zip	:	13202-3064
Country	:	US
Telephone Number	:	315-464-4472
Fax Number	:

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

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	04/06/2009

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Directions to “ HANSEN A YUAN MD” Practice Location

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