Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 3800 | CT |
NPI | 1003362351 |
---|---|
Provider Name | Mr. Peter Samir Hanna |
First Address | Danbury, CT 06810-5733 |
Second Address | Waterbury, CT 06708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2016 |
Last Update Date | 08/07/2018 |