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SAM HANNA is physician registered in the Centers for Medicare & Medicaid Services (CMS). The National Provider Identifier (NPI) of the National Plan and Provider Enumeration System (NPPES) is 1316971229. The unique individual professional ID assigned by Provider Enrollment, Chain, and Ownership System (PECOS) is 9830292762. The primary specialty is PHYSICAL THERAPY. The organization is PRO FORM PHYSICAL THERAPY PC. The address is 8637 102ND RD, , OZONE PARK, NY, 114162134. The zip code is 114162134.
|Nation Provider ID||1316971229|
|PAC ID by PECOS||9830292762|
|Professional Enrollment ID||I20070314000533|
|Medical School Name||OTHER|
|Primary Specialty||PHYSICAL THERAPY|
|All secondary specialties|
|Organization Name||PRO FORM PHYSICAL THERAPY PC|
|Group Practice PAC ID||648404137|
|Number of Group Practice members||1|
|Address||8637 102ND RD, , OZONE PARK, NY, 114162134|
|Hospital affiliation LBN|