Provider Demographics
NPI:1588625859
Name:HANNA, MANAR (MD)
Entity Type:Individual
Prefix:DR
First Name:MANAR
Middle Name:
Last Name:HANNA
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 1:117 STATE ROUTE 35
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-1885
Mailing Address - Country:US
Mailing Address - Phone:732-542-4411
Mailing Address - Fax:732-542-1070
Practice Address - Street 1:117 STATE ROUTE 35
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-1885
Practice Address - Country:US
Practice Address - Phone:732-542-4411
Practice Address - Fax:732-542-1070
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07738500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0082929Medicaid
NJ0082929Medicaid