Individual
JAN P HANGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6177
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 536-4530
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
1038
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1200445
—
MA
Enumeration date
10/19/2006
Last updated
07/08/2007
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