Wagner, Rudolph Steven

Wagner, Rudolph Steven is an sole proprietor health care provider with primary practice located at 288 Millburn Ave , Millburn NJ 07041-1622. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Wagner, Rudolph Steven can be contacted via phone (973) 912-9199.

Contact Information

Primary practice address
288 Millburn Ave Millburn NJ 07041-1622
Fax: (973) 912-0800
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 25MA03649700 New Jersey

Profile Details

NPI number 1366484222
LBN Legal business name Wagner, Rudolph Steven
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 12th, 2006
Last updated Apr 21st, 2022 - 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 1366484222 NPPES
New Jersey MEDICAID 3070107
New Jersey MEDICAID 3070107-01

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