Provider Demographics
NPI:1437143377
Name:MILLER, HANAN (MD)
Entity type:Individual
Prefix:DR
First Name:HANAN
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3715 BEDFORD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1703
Mailing Address - Country:US
Mailing Address - Phone:718-377-7988
Mailing Address - Fax:
Practice Address - Street 1:2266 CROPSEY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-5706
Practice Address - Country:US
Practice Address - Phone:718-266-6100
Practice Address - Fax:718-265-3344
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY209678207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HO4261Medicare UPIN
0695X1Medicare ID - Type Unspecified
832931Medicare ID - Type Unspecified