Provider Demographics
NPI:1598876963
Name:HAGER, ROBERT DAVID (PA-C)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:DAVID
Last Name:HAGER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 PLAINSBORO RD
Mailing Address - Street 2:
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-1915
Mailing Address - Country:US
Mailing Address - Phone:973-886-2506
Mailing Address - Fax:
Practice Address - Street 1:5 PLAINSBORO RD
Practice Address - Street 2:SUITE 260
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536-1915
Practice Address - Country:US
Practice Address - Phone:973-886-2506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00103400363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ068470AG3Medicare PIN
NJP85249Medicare UPIN