Provider Demographics
NPI:1124076914
Name:HAHN, MICHAEL STEWART (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:STEWART
Last Name:HAHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1127
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12402-1127
Mailing Address - Country:US
Mailing Address - Phone:845-334-9933
Mailing Address - Fax:845-334-8796
Practice Address - Street 1:138 PINE ST
Practice Address - Street 2:SUITE 150
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-4947
Practice Address - Country:US
Practice Address - Phone:845-334-9933
Practice Address - Fax:845-334-8796
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205656174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist