MEDICARE: DR. KERI ANN HAGENSTON D.C.

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
1	111N00000X	Chiropractor	X011693-1	NY

General Provider Information

NPI Number	:	1497916902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KERI ANN HAGENSTON D.C.

Provider Business Mailing Address
First Line	:	2 TOWER PL
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12203-3735
Country	:	US
Telephone Number	:	518-313-6470
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 TOWER PL
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12203-3735
Country	:	US
Telephone Number	:	518-313-6470
Fax Number	:	888-557-6459

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2008
Last Update Date	:	11/25/2019

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