Individual
MARY M HANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1812 RICHMOND AVE, STATEN ISLAND, NY 10314-3910
(718) 761-0124
(718) 761-1166
Mailing address
1812 RICHMOND AVE, STATEN ISLAND, NY 10314-3910
(718) 761-0124
(718) 761-1166
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
108377
NY
208000000X
Pediatrics Physician
34907
NJ
208000000X
Pediatrics Physician
A23936
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00191777
—
NY
Enumeration date
11/15/2006
Last updated
07/08/2007
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