Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Gavin Michael Hannon

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1992327696

Gavin Michael Hannon is a Student in an Organized Health Care Education/Training Program in Manchester, Connecticut. Practices as a sole proprietor. Licensed in Maine.

Licensed in
ME
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

71 Haynes St
Manchester, CT 06040-4131
Phone: (860) 533-4679
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence DO3611 (ME)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1992327696
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 15, 2020
Last updated in NPPESJuly 20, 2023
Certification dateJuly 20, 2023
Mailing address71 Haynes St, Manchester, CT 06040-4131

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