Provider Demographics
NPI:1255728358
Name:HAGERTY, BRENDAN (MD)
Entity type:Individual
Prefix:
First Name:BRENDAN
Middle Name:
Last Name:HAGERTY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 E NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4756
Mailing Address - Country:US
Mailing Address - Phone:412-359-3166
Mailing Address - Fax:
Practice Address - Street 1:4701 OGLETOWN STANTON RD STE 4200
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2075
Practice Address - Country:US
Practice Address - Phone:302-658-7533
Practice Address - Fax:302-737-7701
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-16
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-00271122086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology