Provider Demographics
NPI:1497916902
Name:HAGENSTON, KERI ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:KERI
Middle Name:ANN
Last Name:HAGENSTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 TOWER PL
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-3735
Mailing Address - Country:US
Mailing Address - Phone:518-313-6470
Mailing Address - Fax:
Practice Address - Street 1:2 TOWER PL
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-3735
Practice Address - Country:US
Practice Address - Phone:518-313-6470
Practice Address - Fax:888-557-6459
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011693-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor