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Individual

MR. PETER SAMIR HANNA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
64 ROBBINS ST, WATERBURY, CT 06708
(704) 340-5079
Mailing address
14 4TH ST APT A, DANBURY, CT 06810-5733
(704) 340-5079

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
3800
CT
363A00000X
Physician Assistant
1990
WV
363AM0700X
Medical Physician Assistant
Primary
3800
CT

Other

Enumeration date
08/28/2016
Last updated
07/08/2018
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