Provider Demographics
NPI:1679639496
Name:HANSON, ANNA JANG (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:JANG
Last Name:HANSON
Suffix:
Gender:F
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:PO BOX 536
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-0536
Mailing Address - Country:US
Mailing Address - Phone:856-669-6050
Mailing Address - Fax:856-651-0794
Practice Address - Street 1:155 BRIDGETON PIKE
Practice Address - Street 2:SUITE C
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062-2669
Practice Address - Country:US
Practice Address - Phone:856-223-8930
Practice Address - Fax:856-223-8948
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08390400207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ177377Medicaid
NJ127966Medicare PIN
182855Medicare Oscar/Certification