Hanley, Audra
Hanley, Audra is an individual health care provider with primary practice located at 112 Charlton Rd , Ballston Lake NY 12019-2547. She recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as her primary health care specialty. Hanley, Audra can be contacted via phone (518) 399-7723.Contact Information
Primary practice address
112 Charlton Rd
Ballston Lake NY 12019-2547
Phone: (518) 399-7723
Fax: (518) 399-6428
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 204679-5 | New York |
Profile Details
| NPI number | 1588625271 |
|---|---|
| LBN Legal business name | Hanley, Audra |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 31st, 2006 |
| Last updated | Jan 29th, 2013 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588625271 | NPPES |
| New York | MEDICAID | 01866004 |
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