Jeffrey Todd Wagner in Wading River - Orthopedic
Jeffrey Todd Wagner - NPI 1437244050
Jeffrey Todd Wagner is a Orthopedic in Wading River, New York. Jeffrey Todd Wagner practices all healthcare services and medical treatments related to Orthopedic. The NPI Number for Jeffrey Todd Wagner is 1437244050. The last update date is 2007-07-08.
Jeffrey Todd Wagner's current location address is 1 Gateway Drive, Wading River, New York. You can contact this provider via phone number 6319299200 and fax number 6319299201. The mailing address for Jeffrey Todd Wagner is 1 Gateway Drive, Wading River, New York. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jeffrey Todd Wagner |
|---|---|
| Address | 1 Gateway Drive, Wading River, New York |
| Phone Number | 6319299200 |
| Fax Number | 6319299201 |
| Sole Proprietor | Y |
| Credentials | PT, DPT |
NPI Number Detail
| NPI Number | 1437244050 |
|---|---|
| Provider Enumeration Date | 2006-10-03 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1 Gateway Drive |
|---|---|
| City | Wading River |
| State | New York (NY) |
| Post Code | 11792 |
| Phone Number | 6319299200 |
| Fax Number | 6319299201 |
Provider's Primary Taxonomy Detail
| Speciality | Orthopedic |
|---|---|
| Taxonomy | 2251X0800X |
| Licence No | 23281 |
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Definition: A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pat |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 828749 | NY | MANAGED PHYSICAL NETWORK | |
| QN6131 | NY | BC/BS | |
| 127516 | NY | VYTRA |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Jeffrey Todd Wagner by the Centers for Medicare & Medicaid Services?
The Jeffrey Todd Wagner has been issued the NPI (National Provider Identifier) 1437244050, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Where is the Jeffrey Todd Wagner located?
The Jeffrey Todd Wagner is located at 1 Gateway Drive, Wading River, NY 11792.
What is the Jeffrey Todd Wagner's area of specialization and corresponding taxonomy classification?
The Jeffrey Todd Wagner's specialty field is Orthopedic, and it falls under the taxonomy code 2251X0800X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services assign the 1437244050 to Jeffrey Todd Wagner?
The Centers for Medicare & Medicaid Services assigned the 1437244050 to Jeffrey Todd Wagner on 2006-10-03.
As of what date was the information regarding Jeffrey Todd Wagner, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Jeffrey Todd Wagner, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-08.
NPI Number: 1023011681
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