Individual
DR. ELEANOR SUSAN HANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
285 E PARKS HWY, WASILLA, AK 99654-7039
(907) 376-3917
Mailing address
1920 S 10TH ST # 3, PHILADELPHIA, PA 19148-2317
(646) 660-0891
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
3044
MN
152W00000X
Optometrist
OPT6680
CA
152W00000X
Optometrist
Primary
T482
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001945
WELLMARK BCBS
SD
01
—
0696610001
CIGNA MEDICARE
SD
05
—
9202490
—
SD
Enumeration date
07/26/2005
Last updated
03/22/2023
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