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General NPI Number Information
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NPI Number | 1831311570
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Entity Type | Individual
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Provider Name | ELAINE KATHRYN HAAGEN M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 20 NEWBERRY PL
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City | RYE
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State | NY
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Zip | 10580-3337
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Country | US
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Telephone | 914-967-1600
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Fax | 914-967-4993
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Provider Business Mailing Address
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Address Line | 20 NEWBERRY PL
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City | RYE
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State | NY
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Zip | 10580-3337
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Country | US
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Telephone | 914-967-1600
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Fax | 914-967-4993
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0015X
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Taxonomy Name | Psychosomatic Medicine Physician
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License Number | 109613
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License Number State | NY
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