Provider Demographics
NPI:1639861743
Name:HAGER, EMILY KATHERINE
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:KATHERINE
Last Name:HAGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 PARKSIDE AVE APT 3T
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-1352
Mailing Address - Country:US
Mailing Address - Phone:513-460-7420
Mailing Address - Fax:
Practice Address - Street 1:9 E 4TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-6902
Practice Address - Country:US
Practice Address - Phone:646-478-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007235-01171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist