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Contact Information

JEFFREY D WAGNER, PA
18 RONALD LN
SAYVILLE, NY11782-1622
 Phone: 631-750-3924
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for JEFFREY D WAGNER · (Male)

NPI # 1891744967
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 05/08/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers Not Available
Hospital affiliation(s) Not Available
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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