Individual
JILL HAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
363 GRAND AVE, ENGLEWOOD, NJ 07631-4104
(201) 568-6977
(201) 568-7567
Mailing address
363 GRAND AVE, ENGLEWOOD, NJ 07631-4104
(201) 568-6977
(201) 568-7567
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
MD1961
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0063356
GHI
NJ
01
—
0933568
AETNA ID#
NJ
05
—
6198104
—
NJ
01
—
8748330
CIGNA ID #
NJ
01
—
J32278
HEALTHNET
NJ
01
—
P1023259
OXFORD HEALTH PLAN
NJ
Enumeration date
07/26/2006
Last updated
02/28/2022
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