Provider Demographics
NPI:1083873160
Name:DR ELEANOR S HANEY PC
Entity Type:Organization
Organization Name:DR ELEANOR S HANEY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELEANOR
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:HANEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:646-660-0891
Mailing Address - Street 1:306 E 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:MILBANK
Mailing Address - State:SD
Mailing Address - Zip Code:57252-3306
Mailing Address - Country:US
Mailing Address - Phone:646-660-0891
Mailing Address - Fax:605-432-6211
Practice Address - Street 1:4611 HIGHWAY 29 S
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-6175
Practice Address - Country:US
Practice Address - Phone:320-762-4044
Practice Address - Fax:320-762-4046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3044152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty