Individual
KATHRYN S HANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
MASSACHUSETTS GENERAL HOSPITAL, 55 FRUIT ST, BOSTON, MA 02114
(617) 726-4600
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-6850
(414) 805-6851
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
47168020
WI
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
289593
MA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
47168
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396079307
—
WI
01
—
47168020
STATE LICENSE
WI
Enumeration date
09/23/2009
Last updated
02/11/2022
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