1972716058 NPI number — PROF. HARTMUT MARTIN HANAUSKE MD PHD

Table of content: PROF. HARTMUT MARTIN HANAUSKE MD PHD (NPI 1972716058)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972716058 NPI number — PROF. HARTMUT MARTIN HANAUSKE MD PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HANAUSKE
Provider First Name:
HARTMUT
Provider Middle Name:
MARTIN
Provider Name Prefix Text:
PROF.
Provider Name Suffix Text:
Provider Credential Text:
MD PHD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HANAUSKE-ABEL
Provider Other First Name:
HARTMUT
Provider Other Middle Name:
MARTIN
Provider Other Name Prefix Text:
PROF.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD PHD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1972716058
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
368 MAURO RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ENGLEWOOD CLIFFS
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07632-1707
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-567-0158
Provider Business Mailing Address Fax Number:
201-567-0169

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
185 S ORANGE AVE
Provider Second Line Business Practice Location Address:
MSB E-506
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07103-2757
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-972-5276
Provider Business Practice Location Address Fax Number:
973-972-0178
Provider Enumeration Date:
05/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2080H0002X , with the licence number:  25MA07525000 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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