Wagner, Lance W.

Wagner, Lance W. is an individual health care provider with primary practice located at 450 Clarkson Ave , Brooklyn NY 11203-2056. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Wagner, Lance W. can be contacted via phone (718) 270-3126.

Contact Information

Primary practice address
450 Clarkson Ave Brooklyn NY 11203-2056
Phone: (718) 270-3126
Fax: (718) 270-3797
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 186118-1 New York

Profile Details

NPI number 1720072911
LBN Legal business name Wagner, Lance W.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 2nd, 2005
Last updated Jan 4th, 2017 - about 9 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 1720072911 NPPES
New York MEDICAID 01401298

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