Individual
BARBARA MARIE HANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
120 VALLEY RD, MONTCLAIR, NJ 07042-2321
(201) 490-4333
Mailing address
5000 RIVERDALE RD APT 116, RIVERDALE, NJ 07457-1724
(862) 354-7972
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00649300
NJ
Other
Enumeration date
10/01/2021
Last updated
10/01/2021
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