Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 258769-1 | NY |
NPI | 1003125485 |
---|---|
Provider Name | Dr. Ehab Sabry Hanna |
First Address | Manhasset, NY 11030-3818 |
Second Address | Bay Shore, NY 11706-8408 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2010 |
Last Update Date | 21/07/2017 |