Provider Demographics
NPI:1013278175
Name:HAGENBUCH, DAWN S (MSED)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:S
Last Name:HAGENBUCH
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5456 STATE HIGHWAY 23
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815-3142
Mailing Address - Country:US
Mailing Address - Phone:607-336-3707
Mailing Address - Fax:
Practice Address - Street 1:5456 STATE HIGHWAY 23
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-3142
Practice Address - Country:US
Practice Address - Phone:607-336-3707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist