Bagatell, Jarrod Lawrence

Bagatell, Jarrod Lawrence is an individual health care provider with primary practice located at 115 Fairgrounds Drive , Manlius NY 13104. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bagatell, Jarrod Lawrence can be contacted via phone (315) 682-6165.

Contact Information

Primary practice address
115 Fairgrounds Drive Manlius NY 13104
Fax: (315) 682-7929
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 1979451 New York

Profile Details

NPI number 1144335845
LBN Legal business name Bagatell, Jarrod Lawrence
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 20th, 2006
Last updated Nov 15th, 2010 - about 16 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 1144335845 NPPES
New York MEDICAID 01690422

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