Hagan, Clyde
Hagan, Clyde is an sole proprietor health care provider with primary practice located at 2976 Northern Blvd , Long Island City NY 11101-2822. He recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as his primary health care specialty. Hagan, Clyde can be contacted via phone (347) 510-3644.Contact Information
Primary practice address
2976 Northern Blvd
Long Island City NY 11101-2822
Phone: (347) 510-3644
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X |
Profile Details
| NPI number | 1841467354 |
|---|---|
| LBN Legal business name | Hagan, Clyde |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 14th, 2008 |
| Last updated | May 14th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841467354 | NPPES |
| New York | MEDICAID | 02740141 |
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