Provider Demographics
NPI:1912397696
Name:HANLON, STEVEN
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:HANLON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 ALBANY AVE
Mailing Address - Street 2:
Mailing Address - City:KINDERHOOK
Mailing Address - State:NY
Mailing Address - Zip Code:12106-2302
Mailing Address - Country:US
Mailing Address - Phone:917-685-9905
Mailing Address - Fax:
Practice Address - Street 1:63 ALBANY AVE
Practice Address - Street 2:
Practice Address - City:KINDERHOOK
Practice Address - State:NY
Practice Address - Zip Code:12106-2302
Practice Address - Country:US
Practice Address - Phone:917-685-9905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007929225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist