Provider Demographics
NPI:1699351296
Name:HANCE, FREDERICK PETER
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:PETER
Last Name:HANCE
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:STONY BROOK MEDICINE - GME OFFICE HSC LEVEL 4, ROOM 176
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8430
Mailing Address - Country:US
Mailing Address - Phone:631-638-8517
Mailing Address - Fax:
Practice Address - Street 1:STONY BROOK MEDICINE - GME OFFICE HSC LEVEL 4, ROOM 176
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8430
Practice Address - Country:US
Practice Address - Phone:631-638-8517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program