Provider Demographics
NPI:1629247275
Name:HANE, PATRICIA M (RPH, BS)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:M
Last Name:HANE
Suffix:
Gender:F
Credentials:RPH, BS
Other - Prefix:
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Mailing Address - Street 1:1 ORANGEBURG RD
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:NY
Mailing Address - Zip Code:10962-0000
Mailing Address - Country:US
Mailing Address - Phone:845-359-6100
Mailing Address - Fax:845-359-4102
Practice Address - Street 1:1 ORANGEBURG RD
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:NY
Practice Address - Zip Code:10962-0000
Practice Address - Country:US
Practice Address - Phone:845-359-6100
Practice Address - Fax:845-359-4102
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037859183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00723620Medicaid
NY00723620Medicaid