Provider Demographics
NPI:1568970432
Name:HUNTINGTON, JOHN HANLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HANLEY
Last Name:HUNTINGTON
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 1:14 ANGELA CT
Mailing Address - Street 2:
Mailing Address - City:BEACON
Mailing Address - State:NY
Mailing Address - Zip Code:12508-2634
Mailing Address - Country:US
Mailing Address - Phone:845-765-0391
Mailing Address - Fax:
Practice Address - Street 1:14 ANGELA CT
Practice Address - Street 2:
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508-2634
Practice Address - Country:US
Practice Address - Phone:845-765-0391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-13
Last Update Date:2018-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY135384207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY135384OtherNEW YORK STATE EDUCATION DEPARTMENT