Provider Demographics
NPI:1912992785
Name:HANNA, EMAD S (MD)
Entity type:Individual
Prefix:DR
First Name:EMAD
Middle Name:S
Last Name:HANNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 HEALTHY WAY
Mailing Address - Street 2:ATTN: PHYSICIAN BILLING
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-1551
Mailing Address - Country:US
Mailing Address - Phone:516-255-1600
Mailing Address - Fax:516-255-4672
Practice Address - Street 1:196 MERRICK RD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-1420
Practice Address - Country:US
Practice Address - Phone:516-255-8400
Practice Address - Fax:516-255-4672
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2012-04-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY207421207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02192230Medicaid
NY0297461OtherCIGNA
NY5023B1OtherBCBS
NY113565450OtherBEECH STREET
NY113565450OtherPHCS
NY2983913OtherAETNA HMO
NYP2521453OtherOXFORD
NY000000059758OtherGHI HMO
NY113565450OtherMULTIPLAN
NY4C5143OtherHEALTHNET
NY207421OtherHIP
NY5998029OtherGHI PPO
NY7815287OtherAETNA PPO
NY113565450OtherFIRST HEALTH
NY040426009429OtherFIDELIS
NY1000025101OtherAFFINITY
NY113565450OtherGREAT WEST
NY113565450OtherMAGNACARE
NYAA71616OtherMDNY
NYAA71616OtherMDNY