Individual
THERESA HAGANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1450 CHAMPLIN AVE STE 1, UTICA, NY 13502-3662
(315) 624-9000
(315) 624-9003
Mailing address
1450 CHAMPLIN AVE STE 1, UTICA, NY 13502-3662
(315) 624-9000
(315) 624-9003
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
343415
NY
Other
Enumeration date
09/18/2018
Last updated
03/05/2019
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