Provider Demographics
NPI:1760597728
Name:GAGGIN, HANNA KIM (MD, MPH)
Entity Type:Individual
Prefix:
First Name:HANNA
Middle Name:KIM
Last Name:GAGGIN
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:HAN-NA
Other - Middle Name:
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:55 FRUIT ST
Mailing Address - Street 2:YAWKEY 5B, MGH
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2621
Mailing Address - Country:US
Mailing Address - Phone:617-726-2709
Mailing Address - Fax:617-643-6844
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:YAWKEY 5B, MGH
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-2709
Practice Address - Fax:617-643-6844
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA230005207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine