Provider Demographics
NPI:1568802874
Name:PAPPAS, HANA MARIE (NP)
Entity Type:Individual
Prefix:MS
First Name:HANA
Middle Name:MARIE
Last Name:PAPPAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:HANA
Other - Middle Name:MARIE
Other - Last Name:PANTUSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3711 23RD AVE
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-1901
Mailing Address - Country:US
Mailing Address - Phone:718-721-6166
Mailing Address - Fax:
Practice Address - Street 1:3711 23RD AVE
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-1901
Practice Address - Country:US
Practice Address - Phone:718-721-6166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY643998163W00000X
NJ26NR15509000163WN0002X
NY382438363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03792656Medicaid