Hagen, Jill

Hagen, Jill is an individual health care provider with primary practice located at 363 Grand Ave , Englewood NJ 07631-4104. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as her primary health care specialty. Hagen, Jill can be contacted via phone (201) 568-6977.

Contact Information

Primary practice address
363 Grand Ave Englewood NJ 07631-4104
Phone: (201) 568-6977
Fax: (201) 568-7567
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X MD1961 New Jersey

Profile Details

NPI number 1720001167
LBN Legal business name Hagen, Jill
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2006
Last updated Feb 28th, 2022 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720001167 NPPES
New Jersey MEDICAID 6198104
New Jersey Other 0933568
New Jersey Other 0063356
New Jersey Other 8748330
New Jersey Other P1023259
New Jersey Other J32278

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