Provider Demographics
NPI:1922332485
Name:DR. HANLEN AND ASSOCIATES, LLC
Entity Type:Organization
Organization Name:DR. HANLEN AND ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:HANLEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:814-466-2020
Mailing Address - Street 1:104 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BOALSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16827-1347
Mailing Address - Country:US
Mailing Address - Phone:814-466-2020
Mailing Address - Fax:
Practice Address - Street 1:104 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BOALSBURG
Practice Address - State:PA
Practice Address - Zip Code:16827-1347
Practice Address - Country:US
Practice Address - Phone:814-466-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000563152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA6335090001Medicare NSC