Individual
AN DAN HA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
7524 3RD AVE, BROOKLYN, NY 11209-3104
(718) 816-6500
(718) 816-4677
Mailing address
1100 CLOVE RD, STATEN ISLAND, NY 10301-3648
(718) 816-6500
(718) 816-4677
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
050289
NY
225100000X
Physical Therapist
PT22783
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0891659400
—
FL
Enumeration date
09/30/2006
Last updated
05/10/2023
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