Provider Demographics
NPI:1710116694
Name:HANNES, FLORENCE (OTR)
Entity Type:Individual
Prefix:
First Name:FLORENCE
Middle Name:
Last Name:HANNES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 LAKE RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY MILLS
Mailing Address - State:NY
Mailing Address - Zip Code:12577-5000
Mailing Address - Country:US
Mailing Address - Phone:845-341-4323
Mailing Address - Fax:845-496-5789
Practice Address - Street 1:32 LAKE RD
Practice Address - Street 2:
Practice Address - City:SALISBURY MILLS
Practice Address - State:NY
Practice Address - Zip Code:12577-5000
Practice Address - Country:US
Practice Address - Phone:845-341-4323
Practice Address - Fax:845-496-5789
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001621-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist