Individual
BIANCA HAGEDORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4232 ALBANY POST RD, HYDE PARK, NY 12538-1766
(845) 249-2510
Mailing address
4232 ALBANY POST RD, HYDE PARK, NY 12538-1766
(845) 249-2510
(845) 249-2505
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
028886
NY
363AM0700X
Medical Physician Assistant
028886
NY
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
05/11/2022
Last updated
02/10/2026
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