Wagner-Tanico, Lori

Wagner-Tanico, Lori is an individual health care provider with primary practice located at 950 S Oyster Bay Rd , Hicksville NY 11801-3510. She recently has only one registered license in Nursing Service Providers / Registered Nurse, which is considered as her primary health care specialty. Wagner-Tanico, Lori can be contacted via phone (516) 822-6111.

Contact Information

Primary practice address
950 S Oyster Bay Rd Hicksville NY 11801-3510
Phone: (516) 822-6111
Fax: (516) 369-0553
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 492163 New York

Profile Details

NPI number 1104068816
LBN Legal business name Wagner-Tanico, Lori
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 26th, 2009
Last updated Mar 26th, 2009 - about 15 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 1104068816 NPPES
New York MEDICAID 492163

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