Provider Demographics
NPI:1891825188
Name:HANAC, INC.
Entity Type:Organization
Organization Name:HANAC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:KAITERIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-840-8005
Mailing Address - Street 1:49 W 45TH ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-4603
Mailing Address - Country:US
Mailing Address - Phone:212-840-8005
Mailing Address - Fax:212-840-8384
Practice Address - Street 1:3114 30TH AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-1530
Practice Address - Country:US
Practice Address - Phone:718-204-1200
Practice Address - Fax:718-204-1276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02799168Medicaid