Provider Demographics
NPI:1083283436
Name:BROVKA, HANNA
Entity Type:Individual
Prefix:
First Name:HANNA
Middle Name:
Last Name:BROVKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5285 ONONDAGA RD
Mailing Address - Street 2:
Mailing Address - City:CAMILLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13031-9711
Mailing Address - Country:US
Mailing Address - Phone:315-552-8256
Mailing Address - Fax:
Practice Address - Street 1:5285 ONONDAGA RD
Practice Address - Street 2:
Practice Address - City:CAMILLUS
Practice Address - State:NY
Practice Address - Zip Code:13031-9711
Practice Address - Country:US
Practice Address - Phone:315-552-8256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist