Provider Demographics
NPI:1699464214
Name:HANNA, AMIR MAHROUS YOUNAN (PT, DPT)
Entity type:Individual
Prefix:
First Name:AMIR MAHROUS YOUNAN
Middle Name:
Last Name:HANNA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 FOCH BLVD
Mailing Address - Street 2:
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596-1010
Mailing Address - Country:US
Mailing Address - Phone:516-216-0867
Mailing Address - Fax:
Practice Address - Street 1:6421 FRESH POND RD
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-3330
Practice Address - Country:US
Practice Address - Phone:631-494-7572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-01
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04733101225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist