Provider Demographics
NPI:1194881052
Name:HAHN, JAMES P (DO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:HAHN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-4339
Mailing Address - Country:US
Mailing Address - Phone:617-774-0780
Mailing Address - Fax:617-774-0795
Practice Address - Street 1:1250 HANCOCK ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4339
Practice Address - Country:US
Practice Address - Phone:617-774-0780
Practice Address - Fax:617-774-0795
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3950152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0313751Medicaid
MA794890OtherTUFTS
MA0014564OtherNHP
MA1198402-002OtherCIGNA
MAW16134OtherBCBS
MAPE299OtherHPHC
MAU76119Medicare UPIN
MAW17258Medicare PIN