Provider Demographics
NPI:1801928304
Name:HANNA, GEORGE J (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:J
Last Name:HANNA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 STUART RD W
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-7507
Mailing Address - Country:US
Mailing Address - Phone:609-356-0731
Mailing Address - Fax:
Practice Address - Street 1:1805 STUART RD W
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-7507
Practice Address - Country:US
Practice Address - Phone:267-305-3866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD417968207RI0200X
NJ25MA08684200207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3148165Medicaid
MA3148165Medicaid