Individual
KATY-ANN E. HANNIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
250 GREEN ST, SUITE 212, GARDNER, MA 01440-1396
(978) 630-5030
(855) 248-9859
Mailing address
250 GREEN ST, STE 110, GARDNER, MA 01440-1377
(978) 630-5030
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
219096
MA
208M00000X
Hospitalist Physician
219096
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2018918
—
MA
Enumeration date
10/28/2005
Last updated
11/16/2020
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