Wagner, Gerald
Wagner, Gerald is an individual health care provider with primary practice located at 21 Montauk Ave , New London CT 06320-4906. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Wagner, Gerald can be contacted via phone (860) 271-4715.Contact Information
Primary practice address
21 Montauk Ave
New London CT 06320-4906
Phone: (860) 271-4715
Fax: (860) 271-4797
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 000326 | Connecticut |
Profile Details
| NPI number | 1962759084 |
|---|---|
| LBN Legal business name | Wagner, Gerald |
| Credentials | LADC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 8th, 2012 |
| Last updated | Dec 21st, 2016 - about 9 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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