Provider Demographics
NPI:1215174347
Name:HANLEY, ERIN M (MD)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:HANLEY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:750 E ADAMS ST
Mailing Address - Street 2:PEDIATRIC EMERGENCY MEDICINE JACOBSEN HALL 9TH FLOOR
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-2342
Mailing Address - Country:US
Mailing Address - Phone:315-464-4363
Mailing Address - Fax:315-464-8690
Practice Address - Street 1:750 E ADAMS ST
Practice Address - Street 2:PEDIATRIC EMERGENCY MEDICINE JACOBSEN HALL 9TH FLOOR
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2342
Practice Address - Country:US
Practice Address - Phone:315-464-4363
Practice Address - Fax:315-464-8690
Is Sole Proprietor?:No
Enumeration Date:2009-01-12
Last Update Date:2011-09-06
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Provider Licenses
StateLicense IDTaxonomies
NY2602172080P0204X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03350209Medicaid
NY03350209Medicaid