Provider Demographics
NPI:1922695469
Name:HAN, ERIC NURI (MHC-LP)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:NURI
Last Name:HAN
Suffix:
Gender:M
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 NAVY LN
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:CT
Mailing Address - Zip Code:06426-1328
Mailing Address - Country:US
Mailing Address - Phone:917-971-1157
Mailing Address - Fax:
Practice Address - Street 1:280 MADISON AVE RM 210
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0816
Practice Address - Country:US
Practice Address - Phone:646-389-5801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2021-04-28
Deactivation Date:2021-01-04
Deactivation Code:
Reactivation Date:2021-04-28
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health