Basic Information
Provider Information
NPI: 1487303897
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BANK
FirstName: HANNAH
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD, PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 717 S 11TH ST
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191471903
CountryCode: US
TelephoneNumber: 2404756382
FaxNumber:  
Practice Location
Address1: 55 FRUIT ST
Address2:  
City: BOSTON
State: MA
PostalCode: 021142696
CountryCode: US
TelephoneNumber: 6177262000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/22/2022
LastUpdateDate: 03/22/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/22/2022

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

No ID Information.


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