Individual
JEREMY RYAN HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
451 CLARKSON AVE BLDG E, BROOKLYN, NY 11203-2054
(718) 245-3131
(718) 245-3687
Mailing address
451 CLARKSON AVE BLDG E, BROOKLYN, NY 11203-2054
(718) 245-3131
(718) 245-3687
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
291797
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05994165
—
NY
Enumeration date
03/18/2016
Last updated
11/24/2020
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