Individual
FANAH HAGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
119 WINDSOR ST, CAMBRIDGE, MA 02139-3647
(617) 665-3600
Mailing address
119 WINDSOR ST, CAMBRIDGE, MA 02139-3647
(617) 665-3600
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN2282817
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN2282817
NURSING LICENCE
MA
Enumeration date
05/07/2018
Last updated
06/16/2018
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