Individual
DR. WILHELM GUSTAV HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
1013 HECTOR ST, ITHACA, NY 14850-2037
(607) 273-2643
Mailing address
1013 HECTOR ST, ITHACA, NY 14850-2037
(607) 273-2643
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
90793
NY
Other
Enumeration date
07/28/2008
Last updated
07/28/2008
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