Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 13036 | MA |
NPI | 1053351841 |
---|---|
Provider Name | Dr. Joseph B Hanley JR. |
First Address | Northampton, MA 01053-1650 |
Second Address | Leeds, MA 01053-9764 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 08/08/2007 |