Basic Information
| Provider Information | |||||||||
| NPI: | 1174079784 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | KAHHAT | ||||||||
| FirstName: | HANNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 152 NOTTINGHAM PL | ||||||||
| Address2: | |||||||||
| City: | BOYNTON BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334268430 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5204409633 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2259 A WEST HILLSBORO BLVD | ||||||||
| Address2: | |||||||||
| City: | DEERFIELD BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33442 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547254160 | ||||||||
| FaxNumber: | 5617254170 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2016 | ||||||||
| LastUpdateDate: | 09/01/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | 27003 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.