Provider Demographics
NPI:1912226457
Name:GO, HANS (RPH)
Entity Type:Individual
Prefix:MR
First Name:HANS
Middle Name:
Last Name:GO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4948 167TH ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11365-1007
Mailing Address - Country:US
Mailing Address - Phone:718-445-0840
Mailing Address - Fax:
Practice Address - Street 1:3175 23RD ST
Practice Address - Street 2:ICORE HEALTHCARE SUITE 410
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11106-4134
Practice Address - Country:US
Practice Address - Phone:800-350-8119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0486001835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology