Wackett, Andrew

Wackett, Andrew is an individual health care provider with primary practice located at University Hospital, L4 , Stony Brook NY 11794-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Wackett, Andrew can be contacted via phone (631) 444-2499.

Contact Information

Primary practice address
University Hospital, L4 Stony Brook NY 11794-0001
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 213860 New York

Profile Details

NPI number 1649215740
LBN Legal business name Wackett, Andrew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2006
Last updated Jul 8th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649215740 NPPES
New York Other 7074586 AETNA
New York Other 62Q082 AETNA
New York MEDICAID 02108478 AETNA

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