Provider Demographics
NPI:1972068591
Name:TAHA, HANANE
Entity Type:Individual
Prefix:
First Name:HANANE
Middle Name:
Last Name:TAHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 AUTUMN RD
Mailing Address - Street 2:
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-1675
Mailing Address - Country:US
Mailing Address - Phone:617-347-7012
Mailing Address - Fax:
Practice Address - Street 1:242 SUTTON ST
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-1631
Practice Address - Country:US
Practice Address - Phone:978-655-1987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-07
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2263434207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine