Provider Demographics
NPI:1295033249
Name:HANNA, ABIGAIL K (MD)
Entity Type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:K
Last Name:HANNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CASSANDRA BLVD
Mailing Address - Street 2:UNIT 106
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-3144
Mailing Address - Country:US
Mailing Address - Phone:860-548-9574
Mailing Address - Fax:
Practice Address - Street 1:25 CASSANDRA BLVD
Practice Address - Street 2:UNIT 106
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-3144
Practice Address - Country:US
Practice Address - Phone:860-548-9574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT037695208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery