Individual
MICHAEL HAGGERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
535 E 70TH ST, NEW YORK, NY 10021-4898
(212) 606-1000
Mailing address
78 CARDINAL LN, HAUPPAUGE, NY 11788-2118
(631) 609-7523
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
030811-01
NY
Other
Enumeration date
10/09/2023
Last updated
10/09/2023
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