Individual
ERIC DAVID HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
ELM AND CARLTON STREETS, BUFFALO, NY 14263-4494
(716) 845-2300
Mailing address
3708 N HERMITAGE AVE, APT 1, CHICAGO, IL 60613-3509
(315) 576-0590
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
288063
NY
2081H0002X
Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
Primary
288063
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2013
Last updated
01/14/2021
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