Healthcare Provider Details

I. General information

NPI: 1255728358
Provider Name (Legal Business Name): BRENDAN HAGERTY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2015
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 OGLETOWN STANTON RD STE 4200
NEWARK DE
19713-2075
US

IV. Provider business mailing address

320 E NORTH AVE
PITTSBURGH PA
15212-4756
US

V. Phone/Fax

Practice location:
  • Phone: 302-658-7533
  • Fax: 302-737-7701
Mailing address:
  • Phone: 412-359-3166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberC1-0027112
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: