Basic Information
Provider Information
NPI: 1124649439
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HANIF
FirstName: HAMZA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 501 SOUTH WASHINGTON AVENUE
Address2: THE WRIGHT CENTER FOR GRADUATE MEDICAL EDUCATION
City: SCRANTON
State: PA
PostalCode: 18505
CountryCode: US
TelephoneNumber: 5703432383
FaxNumber: 5703434800
Practice Location
Address1: 501 S WASHINGTON AVENUE
Address2:  
City: SCRANTON
State: PA
PostalCode: 18505
CountryCode: US
TelephoneNumber: 5703432383
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/28/2020
LastUpdateDate: 05/27/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/27/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X PAY Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


Home