Individual
TY HAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
709 PARK AVE, LAUREL SPRINGS, NJ 08021-3131
(609) 781-1744
Mailing address
709 PARK AVE, LAUREL SPRINGS, NJ 08021-3131
(609) 781-1744
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/07/2023
Last updated
07/25/2025
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