Wagner, John Raymond
Wagner, John Raymond is an individual health care provider with primary practice located at 7 Pulaski Rd , East Northport NY 11731-2442. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Wagner, John Raymond can be contacted via phone (631) 261-3322.Contact Information
Primary practice address
7 Pulaski Rd
East Northport NY 11731-2442
Phone: (631) 261-3322
Fax: (631) 368-5440
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 181212 | New York |
Profile Details
| NPI number | 1538120704 |
|---|---|
| LBN Legal business name | Wagner, John Raymond |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 29th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538120704 | NPPES |
| New York | MEDICAID | 01280253 |
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