Provider Demographics
NPI:1518315001
Name:HANNA, ALICIA (MOTR/L)
Entity Type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:
Last Name:HANNA
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:381 I U WILLETS RD
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2813
Mailing Address - Country:US
Mailing Address - Phone:347-728-8316
Mailing Address - Fax:
Practice Address - Street 1:255 EXECUTIVE DRIVE SUITE LL-108
Practice Address - Street 2:ALL ABOUT KIDS
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1704
Practice Address - Country:US
Practice Address - Phone:516-576-2040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015636-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist