Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 042-0014691 | VT |
Y | 207RC0000X | Internist - Cardiovascular Disease | A49513 | CA |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | A49513 | CA |
NPI | 1073722674 |
---|---|
Provider Name | Dr. Tracy Elizabeth Hagerty |
First Address | Pittsfield, MA 01201-4109 |
Second Address | Pittsfield, MA 01201-4109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 10/03/2020 |