Individual
DAVID THOMAS HANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3669 COUNTRYSIDE LN, MARION, NY 14505-9781
(315) 926-7733
(315) 926-0731
Mailing address
3669 COUNTRYSIDE LN, PO BOX 110, MARION, NY 14505-9781
(315) 926-7733
(315) 926-0731
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
156845
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010156845
BLUE CHOICE
NY
05
—
01389073
—
NY
01
—
MD109B
PREFERRED CARE
NY
Enumeration date
07/14/2006
Last updated
09/14/2016
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