Provider Demographics
NPI:1891765657
Name:HANKE, NORA E (MB,CHB)
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:E
Last Name:HANKE
Suffix:
Gender:F
Credentials:MB,CHB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-1473
Mailing Address - Country:US
Mailing Address - Phone:413-527-2101
Mailing Address - Fax:413-527-3849
Practice Address - Street 1:4 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-1448
Practice Address - Country:US
Practice Address - Phone:413-527-2101
Practice Address - Fax:413-527-3849
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA158786208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA158786OtherCONNECTICARE
MA3185508Medicaid
MA24026OtherHEALTH NEW ENGLAND
MA102208Other102208
MA28499OtherCHILDRENS MEDICAL SECURIT
MA000000008119OtherBMC HEALTHNET
MA158786OtherTUFTS HEALTH PLAN
MA2381527OtherAETNA
MAJ19593OtherBLUE CROSS AND BLUE SHIEL
MA158786OtherTUFTS HEALTH PLAN
MA24026OtherHEALTH NEW ENGLAND