Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | C002515 | MD |
NPI | 1649287202 |
---|---|
Provider Name | Mary Ann Hannah |
First Address | Philadelphia, PA 19178-3311 |
Second Address | Bethlehem, PA 18017-7326 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 18/12/2015 |