Provider Demographics
NPI:1730165010
Name:HANGASKY, SUZANNE PHILLIPS (NP)
Entity type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:PHILLIPS
Last Name:HANGASKY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 WEST AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:MA
Mailing Address - Zip Code:01056-1738
Mailing Address - Country:US
Mailing Address - Phone:413-610-2201
Mailing Address - Fax:877-654-1052
Practice Address - Street 1:185 WEST AVE STE 204
Practice Address - Street 2:
Practice Address - City:LUDLOW
Practice Address - State:MA
Practice Address - Zip Code:01056-1738
Practice Address - Country:US
Practice Address - Phone:413-610-2201
Practice Address - Fax:877-654-1052
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA206884363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
S96962Medicare UPIN
500017170Medicare PIN
MANP2174Medicare PIN