Individual
LEE N HANUSCHAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
829 SPRUCE ST, SUITE 304, PHILADELPHIA, PA 19107-5752
(215) 627-1404
Mailing address
149 WHITEMARSH RD, ARDMORE, PA 19003-1634
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MD021132E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0709078
—
PA
Enumeration date
06/03/2006
Last updated
03/25/2011
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