Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | MD042711E | PA |
Y | 207W00000X | Ophthalmologist | MD042711E | PA |
NPI | 1780637942 |
---|---|
Provider Name | Dr. Sadeer B Hannush |
First Address | Langhorne, PA 19047-1819 |
Second Address | Langhorne, PA 19047-1819 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 14/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0115036000 | KEYSTONE HEALTH PLAN EAST (01) | PA |
232550551 | HORIZON (01) | NJ |
428668 | BLUE CROSS/BLUE SHIELD (01) | PA |
57059 | AETNA (01) | PA |
B41654 | (02) | PA |