Provider Demographics
NPI:1992287510
Name:HAMAN, GERISHMA KUNWAR (APN)
Entity type:Individual
Prefix:
First Name:GERISHMA
Middle Name:KUNWAR
Last Name:HAMAN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:GERISHMA
Other - Middle Name:
Other - Last Name:KUNWAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:256 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06042-2004
Mailing Address - Country:US
Mailing Address - Phone:860-696-2300
Mailing Address - Fax:
Practice Address - Street 1:5700 S MARYLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1426
Practice Address - Country:US
Practice Address - Phone:646-584-2298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9024363LF0000X
IL209.019078363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily