Provider Demographics
NPI:1487649372
Name:HANAN, SCOTT H (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:H
Last Name:HANAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 E 15TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4017
Mailing Address - Country:US
Mailing Address - Phone:212-614-6770
Mailing Address - Fax:212-598-9181
Practice Address - Street 1:306 E 15TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4017
Practice Address - Country:US
Practice Address - Phone:212-614-6770
Practice Address - Fax:212-598-9181
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1993062086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG45255Medicare UPIN
NY66L-001Medicare ID - Type Unspecified