Wagner, Phyllis J

Wagner, Phyllis J is an sole proprietor health care provider with primary practice located at 4 Crawford St , Cambridge MA 02139-1624. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Wagner, Phyllis J can be contacted via phone (617) 492-2855.

Contact Information

Primary practice address
4 Crawford St Cambridge MA 02139-1624
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 37927 Massachusetts

Profile Details

NPI number 1770609844
LBN Legal business name Wagner, Phyllis J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 21st, 2007
Last updated Nov 4th, 2008 - about 17 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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