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NPI Code Detail

MEDICARE: MR. STEPHEN S. HAGGERTY PT

MEDICARE: MR. STEPHEN S. HAGGERTY PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist16466MA

General Provider Information

NPI Number : 1194910968
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEPHEN S. HAGGERTY PT
Provider Business Mailing Address
First Line : 653 SUMMER ST
Second Line : 2ND FLOOR
City : BOSTON
State : MA
Zip : 02210-2108
Country : US
Telephone Number : 617-269-6262
Fax Number : 614-269-1068
Provider Business Practice Location Address
First Line : 653 SUMMER ST
Second Line : 2ND FLOOR
City : BOSTON
State : MA
Zip : 02210-2108
Country : US
Telephone Number : 617-269-6262
Fax Number : 614-269-1068
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2007
Last Update Date : 09/17/2007

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Directions to “ MR. STEPHEN S. HAGGERTY PT” Practice Location

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