Wagner, Jack
Wagner, Jack is an sole proprietor health care provider with primary practice located at 37 Wilputte Pl , New Rochelle NY 10804-1426. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Wagner, Jack can be contacted via phone (914) 636-5678.Contact Information
Primary practice address
37 Wilputte Pl
New Rochelle NY 10804-1426
Phone: (914) 636-5678
Fax: (914) 235-0153
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 90773 | New York |
Profile Details
| NPI number | 1578775326 |
|---|---|
| LBN Legal business name | Wagner, Jack |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 4th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 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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