Provider Demographics
NPI:1164081410
Name:HANNA, CHERRY MARIA (OD)
Entity Type:Individual
Prefix:DR
First Name:CHERRY
Middle Name:MARIA
Last Name:HANNA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MS
Other - First Name:CHERRY
Other - Middle Name:MARIA
Other - Last Name:GIRGIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1309 CRICKET LN
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-1595
Mailing Address - Country:US
Mailing Address - Phone:848-219-9034
Mailing Address - Fax:
Practice Address - Street 1:509 STILLWELLS CORNER RD STE E5
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2965
Practice Address - Country:US
Practice Address - Phone:732-431-3312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA005964000152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist