Provider Demographics
NPI:1720586266
Name:UNG, HANORA
Entity type:Individual
Prefix:
First Name:HANORA
Middle Name:
Last Name:UNG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2441 BLACK RIVER FALLS DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89044-1007
Mailing Address - Country:US
Mailing Address - Phone:702-856-6026
Mailing Address - Fax:
Practice Address - Street 1:2441 BLACK RIVER FALLS DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89044-1007
Practice Address - Country:US
Practice Address - Phone:702-856-6026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-30
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant