Provider Demographics
NPI:1881765519
Name:HANLEY, CLAIRE (MD)
Entity type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:
Last Name:HANLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 CLARKSON AVE
Mailing Address - Street 2:BOX 1262
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2056
Mailing Address - Country:US
Mailing Address - Phone:718-270-8867
Mailing Address - Fax:718-270-1794
Practice Address - Street 1:450 CLARKSON AVE
Practice Address - Street 2:BOX 1198
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2056
Practice Address - Country:US
Practice Address - Phone:718-270-1603
Practice Address - Fax:718-270-2667
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2024-08-09
Deactivation Date:2020-07-29
Deactivation Code:
Reactivation Date:2024-08-09
Provider Licenses
StateLicense IDTaxonomies
NY1893932085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01761031Medicaid
NY01761031Medicaid
NY32X351Medicare ID - Type Unspecified