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Individual

DR. JENNIFER A. HAGERTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1600 ROCKLAND ROAD, WILMINGTON, DE 19803-3607
(302) 651-4200
(302) 651-6410
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-6212

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
036-113383
IL
208800000X
Urology Physician
Primary
C20009386
DE
2088P0231X
Pediatric Urology Physician
OS010769L
PA

Other

Enumeration date
04/22/2007
Last updated
09/26/2011
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