Provider Demographics
NPI:1639228133
Name:HANSMAN, NORMAN
Entity Type:Individual
Prefix:MR
First Name:NORMAN
Middle Name:
Last Name:HANSMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11024-1828
Mailing Address - Country:US
Mailing Address - Phone:516-482-6132
Mailing Address - Fax:718-478-7731
Practice Address - Street 1:6222 WOODHAVEN BLVD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2745
Practice Address - Country:US
Practice Address - Phone:718-478-4600
Practice Address - Fax:718-478-7731
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019722-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist