Provider Demographics
NPI:1710162201
Name:HANSANA, BINA PATEL
Entity Type:Individual
Prefix:
First Name:BINA
Middle Name:PATEL
Last Name:HANSANA
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:BINAKUMARI
Other - Middle Name:BHIKHUBHAI
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 742616
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-2616
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1404 RIVER PL
Practice Address - Street 2:SUITE 201
Practice Address - City:BRASELTON
Practice Address - State:GA
Practice Address - Zip Code:30517-5600
Practice Address - Country:US
Practice Address - Phone:770-219-4000
Practice Address - Fax:770-219-4001
Is Sole Proprietor?:No
Enumeration Date:2008-01-03
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5259363A00000X
GA005259363AS0400X
NC0010-02271363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2762296AMedicare PIN
NC2762296Medicare PIN