Individual
DR. AUDRA HANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
112 CHARLTON RD, BALLSTON LAKE, NY 12019-2547
(518) 399-7723
(518) 399-6428
Mailing address
112 CHARLTON RD, BALLSTON LAKE, NY 12019-2547
(518) 399-7723
(518) 399-6428
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
204679-5
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01866004
—
NY
Enumeration date
03/31/2006
Last updated
01/29/2013
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