Provider Demographics
NPI:1104926823
Name:HAJAGOS, KATHLEEN JUDITH (RN MS)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:JUDITH
Last Name:HAJAGOS
Suffix:
Gender:F
Credentials:RN MS
Other - Prefix:MISS
Other - First Name:KATHLEEN
Other - Middle Name:JUDITH
Other - Last Name:ESZTERHAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:25 LONE OAK DR
Mailing Address - Street 2:
Mailing Address - City:CENTERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11721
Mailing Address - Country:US
Mailing Address - Phone:631-271-7368
Mailing Address - Fax:631-266-6040
Practice Address - Street 1:78 MIDDLEVILLE ROAD
Practice Address - Street 2:118
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768
Practice Address - Country:US
Practice Address - Phone:631-261-4400
Practice Address - Fax:631-266-6040
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203937163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse