Provider Demographics
NPI:1841606803
Name:HAHN, DAVID (FNP)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:HAHN
Suffix:
Gender:M
Credentials:FNP
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 423
Mailing Address - Street 2:
Mailing Address - City:PENN YAN
Mailing Address - State:NY
Mailing Address - Zip Code:14527-0423
Mailing Address - Country:US
Mailing Address - Phone:315-531-9102
Mailing Address - Fax:315-531-9103
Practice Address - Street 1:60 MAIN STREET
Practice Address - Street 2:
Practice Address - City:PT BYRON
Practice Address - State:NY
Practice Address - Zip Code:13140-0359
Practice Address - Country:US
Practice Address - Phone:315-776-9700
Practice Address - Fax:315-776-9701
Is Sole Proprietor?:No
Enumeration Date:2014-07-10
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY338919363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03923159Medicaid