Provider Demographics
NPI:1528484573
Name:TANALSKI, HANNAH
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:TANALSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39A FOXBERRY DR
Mailing Address - Street 2:GETZVILLE
Mailing Address - City:GETZVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14068-1023
Mailing Address - Country:US
Mailing Address - Phone:585-771-0223
Mailing Address - Fax:
Practice Address - Street 1:39A FOXBERRY DR
Practice Address - Street 2:GETZVILLE
Practice Address - City:GETZVILLE
Practice Address - State:NY
Practice Address - Zip Code:14068-1023
Practice Address - Country:US
Practice Address - Phone:585-771-0223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-14
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY709996131174400000X
NY710224231174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist