Provider Demographics
NPI:1225034069
Name:HANIN, LAURIE (PHD)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:HANIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11045 71ST RD
Mailing Address - Street 2:APT 6B
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4966
Mailing Address - Country:US
Mailing Address - Phone:718-793-4527
Mailing Address - Fax:
Practice Address - Street 1:50 BROADWAY
Practice Address - Street 2:FL 6
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-3810
Practice Address - Country:US
Practice Address - Phone:917-305-7700
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY493231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYM21851Medicare ID - Type Unspecified