Provider Demographics
NPI:1639155096
Name:HANAUER, ERIC J (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:J
Last Name:HANAUER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 MERRICK RD FL 1
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-2526
Mailing Address - Country:US
Mailing Address - Phone:516-887-3516
Mailing Address - Fax:516-887-0331
Practice Address - Street 1:777 SUNRISE HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-2950
Practice Address - Country:US
Practice Address - Phone:516-887-3516
Practice Address - Fax:516-887-0331
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2120462084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY8231003Other8231003
NY02272508Medicaid
NY112573413OtherHUM,FIRSTHEALTH,HORIZ,MAG
NY212046OtherHEALTHCARE PARTNERS
NY3001274OtherGHI
NY417N21OtherBC BS
NY4C2978OtherHEALTH NET
NY137211OtherVYTRA
NY130025337OtherRAILROAD MEDICARE
NY12299568OtherMULTIPLAN
NY212046OtherHIP
NYPNN2120464OtherWC, NO FAULT
NYP2639324OtherOXFORD
NY112573413OtherOCM,PHCS,UHC,EMPIRE PLAN
NY130025337OtherRAILROAD MEDICARE
NY137211OtherVYTRA