Provider Demographics
NPI:1780648071
Name:HANAN, MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:HANAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10325 68TH AVE
Mailing Address - Street 2:APT 3-0
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3267
Mailing Address - Country:US
Mailing Address - Phone:718-975-0701
Mailing Address - Fax:718-975-0703
Practice Address - Street 1:2401 AVENUE X
Practice Address - Street 2:1ST FLOOR. MICHAEL HANAN MEDICAL P.C.
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2516
Practice Address - Country:US
Practice Address - Phone:718-975-0701
Practice Address - Fax:718-975-0703
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY233117208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics