Individual
CARLOS A HAGANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSN-RN
Contact information
Practice address
502 COURT ST STE 210, UTICA, NY 13502-4233
(315) 507-5800
(315) 507-5802
Mailing address
502 COURT ST STE 210, UTICA, NY 13502-4233
(315) 507-5800
(315) 507-5802
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
733603
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B3261QM1300X
—
NY
Enumeration date
07/02/2018
Last updated
07/02/2018
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