Provider Demographics
NPI:1336122985
Name:HAHN, GARY M (MD)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:M
Last Name:HAHN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:283 COMMACK ROAD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-3400
Mailing Address - Country:US
Mailing Address - Phone:631-462-2300
Mailing Address - Fax:631-462-0159
Practice Address - Street 1:283 COMMACK ROAD
Practice Address - Street 2:SUITE 115
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-3400
Practice Address - Country:US
Practice Address - Phone:631-462-2300
Practice Address - Fax:631-462-0159
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-28
Last Update Date:2013-08-30
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Provider Licenses
StateLicense IDTaxonomies
NY142516207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology