Provider Demographics
NPI:1326812967
Name:HANANI LLC
Entity Type:Organization
Organization Name:HANANI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JABULANI
Authorized Official - Middle Name:
Authorized Official - Last Name:SIDILE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-633-0088
Mailing Address - Street 1:8735 DUNWOODY PL # 4462
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-2995
Mailing Address - Country:US
Mailing Address - Phone:678-257-7452
Mailing Address - Fax:470-242-7719
Practice Address - Street 1:8735 DUNWOODY PL # 4462
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30350-2995
Practice Address - Country:US
Practice Address - Phone:678-257-7452
Practice Address - Fax:470-242-7719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty