Stassen-Wagner, Nicole Anne

Stassen-Wagner, Nicole Anne is an individual health care provider with primary practice located at 601 Elmwood Ave Box Surg, Rochester NY 14642-8410. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Trauma Surgery, Allopathic & Osteopathic Physicians / Surgical Critical Care. Allopathic & Osteopathic Physicians / Trauma Surgery is her primary health care specialty. Stassen-Wagner, Nicole Anne can be contacted via phone (585) 275-3376.

Contact Information

Primary practice address
601 Elmwood Ave Box Surg Rochester NY 14642-8410
Phone: (585) 275-3376
Fax: (585) 276-1992
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Trauma Surgery 2086S0127X 230009 New York
Allopathic & Osteopathic Physicians / Surgical Critical Care 2086S0102X 230009 New York

Profile Details

NPI number 1417984519
LBN Legal business name Stassen-Wagner, Nicole Anne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2006
Last updated Jul 5th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1417984519 NPPES
New York MEDICAID 02497487

Popular Providers