Provider Demographics
NPI: | 1538633359 |
---|---|
Name: | DANIEL HANONO MD PC |
Entity type: | Organization |
Organization Name: | DANIEL HANONO MD PC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DANIEL |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | HANONO |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 646-952-4211 |
Mailing Address - Street 1: | 145 E 32ND ST STE 303 |
Mailing Address - Street 2: | |
Mailing Address - City: | NEW YORK |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 10016-6055 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 646-952-4211 |
Mailing Address - Fax: | 646-952-4208 |
Practice Address - Street 1: | 145 E 32ND ST STE 303 |
Practice Address - Street 2: | |
Practice Address - City: | NEW YORK |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10016-6055 |
Practice Address - Country: | US |
Practice Address - Phone: | 646-952-4211 |
Practice Address - Fax: | 646-952-4208 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-01-15 |
Last Update Date: | 2019-01-15 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 174400000X | Other Service Providers | Specialist | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NY | 105622 | Other | GROUP LICENSE |