Provider Demographics
NPI:1104374487
Name:HAGAR, MEGAN (MS, RD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:HAGAR
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 5TH AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-8728
Mailing Address - Country:US
Mailing Address - Phone:845-325-6560
Mailing Address - Fax:
Practice Address - Street 1:153 VERMILYEA AVE APT 3F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-2436
Practice Address - Country:US
Practice Address - Phone:845-325-6560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-15
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic