Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | MD-425560 | PA |
NPI | 1275585481 |
---|---|
Provider Name | Sophie S Hanna |
First Address | Mars, PA 16046-2325 |
Second Address | Mars, PA 16046-2325 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 10/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101660063 0002 | (05) | PA |
I52977 | (02) | PA |