Wagner, Monta

Wagner, Monta is an individual health care provider with primary practice located at 3344 Chambers Rd Ste 200 , Horseheads NY 14845-1403. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Wagner, Monta can be contacted via phone (607) 734-2264.

Contact Information

Primary practice address
3344 Chambers Rd Ste 200 Horseheads NY 14845-1403
Phone: (607) 734-2264
Fax: (607) 734-2932
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 330195 New York

Profile Details

NPI number 1639101363
LBN Legal business name Wagner, Monta
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2006
Last updated Mar 3rd, 2021 - about 4 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 1639101363 NPPES
New York MEDICAID 01267821
New York Other 161355553

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