Doctor Name: | DR. MAYLENE H. HAN |
NPI Number: | 1336589787 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.O. |
License Number: | OT015252 |
Business Practice Address: | 175 S Wilkes Barre Blvd Geisinger Kistler Clinic Wilkes Barre, PA - 187025040 |
Business Phone Number: | 5708292621 |
Business Fax Number: | |
Mailing Address: | Geisinger Medical Ctr, 100 North Academy Avenue DANVILLE |
State: | PA |
Postal Code: | 178220001 |
Phone Number: | 5708292621 |
Fax Number: | |
NPI Enumeration Date: | 06/30/2013 |
NPI Last Update Date: | 11/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | OT015252 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |