Individual
MAUREEN T HANNIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
601 DUPONT ST, PHILADELPHIA, PA 19128-2615
(215) 483-6948
(215) 483-3839
Mailing address
601 DUPONT ST, PHILADELPHIA, PA 19128
(215) 483-6948
(215) 483-3839
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
DC003526L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0071392000
KEYSTONE HEALTH PLAN EAST
PA
01
—
0467520
AETNA USHC
PA
05
—
071116664
—
PA
01
—
10928301
CAQH
PA
01
—
42548
AWHN
PA
01
—
616812
CIGNA PPO
PA
01
—
J16871
INTERCOUNTY
PA
Enumeration date
02/02/2006
Last updated
04/30/2008
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