Dr. Jack Wagner, MD
Surgery in New Rochelle, New York
1578775326- Practice location
- 37 Wilputte Pl, New Rochelle, NY 10804-1426
- Phone
- 914-636-5678
- Fax
- 914-235-0153
- Last updated
- July 8, 2007
Jack Wagner is a Surgery based in New Rochelle, NY. Jack Wagner practices in New Rochelle, NY and has the professional credentials of MD. The NPI Number for Jack Wagner is 1578775326 and holds a License No. 90773 (NY). The current practice location address for Jack Wagner is 37 Wilputte Pl, New Rochelle, NY 10804-1426 and can be reached out via phone at 914-636-5678 and via fax at 914-235-0153.
Provider Profile Details
- NPI Number
- 1578775326
- Provider Name
- Jack Wagner
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 37 Wilputte Pl, New Rochelle, NY 10804-1426
- Phone Number
- 914-636-5678
- Fax Number
- 914-235-0153
- Primary Taxonomy
- Surgery · 208600000X
- Sole Proprietor
- Yes
- Other Names
- Dr. Jack Wagner, MD (Professional Name)
- Provider Enumeration Date
- May 4, 2007
- Last Update Date
- July 8, 2007
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 37 Wilputte Pl
New Rochelle, NY 10804-1426 - City
- New Rochelle
- State
- New York
- Zip
- 10804-1426
- Phone Number
- 914-636-5678
- Fax Number
- 914-235-0153
Provider Business Mailing Address Details
- Address
- 37 Wilputte Pl
New Rochelle, NY 10804-1426 - City
- New Rochelle
- State
- NY
- Zip
- 10804-1426
- Phone Number
- 914-636-5678
- Fax Number
- 914-235-0153
License Information
- License Number
- 90773
- License State
- NY
- Taxonomy
- Surgery · 208600000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Dr. Jack Wagner, MD?
The NPI number of Dr. Jack Wagner, MD is 1578775326. It was assigned on May 4, 2007 and is currently active in the NPPES registry.
What is the specialty of Dr. Jack Wagner, MD?
Dr. Jack Wagner, MD is registered under the primary taxonomy Surgery (code 208600000X), licensed in NY under license number 90773.
Where does Dr. Jack Wagner, MD practice?
The practice location is 37 Wilputte Pl, New Rochelle, NY 10804-1426. The office can be reached at 914-636-5678 (phone) or 914-235-0153 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1578775326 directly on the NPPES registry website.