| Doctor Name: | DR. JOHN HAGGERTY |
| NPI Number: | 1205146107 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 012879 |
| Business Practice Address: | 82 Rocky Point Yaphank Rd Rocky Point, NY - 117788422 |
| Business Phone Number: | 6318497571 |
| Business Fax Number: | 6315910220 |
| Mailing Address: | 82 Rocky Point Yaphank Rd, ROCKY POINT |
| State: | NY |
| Postal Code: | 117788422 |
| Phone Number: | 6318497571 |
| Fax Number: | 6315910220 |
| NPI Enumeration Date: | 10/14/2010 |
| NPI Last Update Date: | 10/14/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | 012879 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |