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Individual

DR. AVA MARILYN HANSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
133 E 73RD ST, SUITE 209, NEW YORK, NY 10021-3556
(212) 861-9000
(212) 472-6883
Mailing address
133 E 73RD ST, SUITE 209, NEW YORK, NY 10021-3556
(212) 861-9000
(212) 472-6883

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
188167
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01427389
NY
Enumeration date
12/07/2006
Last updated
07/09/2007
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