DR. Jack Wagner, M.D.
NPI #1578775326 in New Rochelle, New York
Provider Information
- NPI Number
- 1578775326
- Entity Type
- Individual
- Name
- DR. Jack Wagner, M.D.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Surgery
- Credential
- M.D.
- Enumeration Date
- May 4, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 37 WILPUTTE PL
- City
- New Rochelle
- State
- New York
- ZIP Code
- 10804-1426
- Phone
- (914) 636-5678
Specialties & Taxonomy Codes
| Specialty |
|---|
| Surgery |
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