Wagner, Jenia

Wagner, Jenia is an individual health care provider with primary practice located at 292 Main St , East Aurora NY 14052-1650. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Wagner, Jenia can be contacted via phone (716) 652-1560.

Contact Information

Primary practice address
292 Main St East Aurora NY 14052-1650
Phone: (716) 652-1560
Fax: (716) 688-0432
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 172214 New York

Profile Details

NPI number 1518939750
LBN Legal business name Wagner, Jenia
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2006
Last updated Mar 6th, 2018 - about 6 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 1518939750 NPPES
New York Other 10166190 FIDELIS
New York Other 00010164304 FIDELIS
New York Other 000524001006 FIDELIS
New York Other 0408107 FIDELIS
New York Other 151114BJ FIDELIS
New York MEDICAID 01608680 FIDELIS

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