Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | N004560 | NY |
NPI | 1083698963 |
---|---|
Provider Name | Roger Adam Hans |
First Address | Astoria, NY 11102-1545 |
Second Address | Astoria, NY 11102-1545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2005 |
Last Update Date | 05/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U35604 | (02) | NY |