Maryann E Hagberg, RD,CDN

Primary specialty

Dietary ManagerTaxonomy code 132700000X

License

000814 Issued in CT

Practice address

130 Division St
Derby, CT 06418-1326

Phone

(203) 732-7585

NPI assigned

Dec 4, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221609600000",
    "number": "1851573687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 SABAL DR",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082166",
            "telephone_number": "203-591-1644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 DIVISION ST",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181326",
            "telephone_number": "203-732-7585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGBERG",
        "first_name": "MARYANN",
        "middle_name": "E",
        "credential": "RD,CDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-04",
        "last_updated": "2008-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "132700000X",
            "taxonomy_group": "",
            "desc": "Dietary Manager",
            "state": "CT",
            "license": "000814",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CT",
            "license": "000814",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Blaise Guarnaccia, M.D.
• Julie Susan Guilmette, LCSW
• Feng Hua Guo, MD
• Elena N Gutman, M.D.
• Patricia Haag, OT
• Dawn Marie Hall, LPC-A
• Dwayne Alansier Hall, DNP
• Edward Halstead, M.D.
• Sana Hanif, M.D
• James E. Haswell, M.D.

• Dietary Manager in Derby, CT
• Providers in Derby, CT by specialty
• Dietary Manager in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.