Provider Demographics
NPI:1700886728
Name:HANLON, DENNIS PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:PAUL
Last Name:HANLON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 E NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212
Mailing Address - Country:US
Mailing Address - Phone:412-359-4138
Mailing Address - Fax:412-359-8874
Practice Address - Street 1:320 E NORTH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212
Practice Address - Country:US
Practice Address - Phone:412-359-4138
Practice Address - Fax:412-359-8874
Is Sole Proprietor?:No
Enumeration Date:2005-08-01
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044319E207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV2006329000Medicaid
PA0012134700001Medicaid
OH2223463Medicaid
PAE28484Medicare UPIN
OH2223463Medicaid
PA930083879Medicare PIN
PACG2169Medicare PIN
PA0012134700001Medicaid
PA930083885Medicare PIN