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Contact Information

RUDOLPH S WAGNER, MD
288 MILLBURN AVE
MILLBURN, NJ07041-1622
 Phone: 973-912-9199
 Fax: 973-912-0800
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for RUDOLPH S WAGNER · (Male)

NPI Number 1366484222
Status Active
Credentials MD
Entity Individual
Enumeration date 06/12/2006
Last updated 04/21/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • NJ License # 25MA03649700
  • NJ Medicaid 3070107
  • NJ Medicaid 3070107-01
Hospital affiliation(s)
  • UMDNJ UNIVERSITY HOSPITAL - (Acute Care)
    150 BERGEN ST
    NEWARK, NJ 07103
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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