ELLIOTT J WAGNER (NPI# 1558312579) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558312579 |
| Entity Type | Individual |
| Full Name | ELLIOTT J WAGNER |
| Credential | M.D. |
| Practice Address |
200 E 66th St Apt C904 New York NY 10065-0163 |
| Mailing Address |
200 East 66th St C904 New York NY 10065-9175 |
| Practice Telephone | 9493784889 |
| Practice Fax Number | 2127522190 |
| Mailing Telephone | 8888865238 |
| Mailing Fax Number | 8888869330 |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2018-10-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
25MA08122100 | NJ | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
238657-1 | NY | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
G49698 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD | 00G496980 | 01 |
| NY | 02917751 | 05 | |
| CA | 00G496980 | 05 |
| Street Address |
200 E 66TH ST APT C904 |
| City | NEW YORK |
| State | NY |
| Zip Code | 10065-0163 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699372706 | Anna Jane Dare | Student in an Organized Health Care Education/Training Program | 1275 York Avenue Department of Surgery, Memorial Sloan, Kettering Cancer Center, New York, NY 10065 | 2020-10-02 |
| 1609480987 | Kimberly Ann Oppenheim | Physician Assistant | 525 E. 68th Street. Box# 325, Inpatient Oncology Pa Service, New York, NY 10065 | 2020-09-03 |
| 1043829252 | Bridget Maginity | Physician Assistant | 1283 York Ave 14th Floor, New York, NY 10065 | 2020-07-24 |
| 1154948016 | Andrew Timothy Mclean | Student in an Organized Health Care Education/Training Program | Memorial Sloan Kettering Cancer Centre, 1275 York Ave, New York, NY 10065 | 2020-06-26 |
| 1972128700 | Seeminder Brar | Anesthesiology | Weill Cornell Medicine - Department of Anesthesiology, 525 East 68th Street, New York, NY 10065 | 2020-06-08 |
| 1114548245 | Mohamed Medhat Soliman | Student in an Organized Health Care Education/Training Program | 525 East 68th Street, Room F734, New York-presbyterian Hospital/weill Cornell Medical Ce, Manhattan, NY 10065 | 2020-04-29 |
| 1700417672 | Carlos Henrique Dos Anjos | Internal Medicine | 300 E 66th St, New York, Ny, New York, NY 10065 | 2020-01-30 |
| 1134788557 | Marvin Herbert Braun | Student in an Organized Health Care Education/Training Program | Department of Neurology, Sixth Floor, Weill Cornell Med, 525 East 68 St., New York, NY 10065 | 2019-06-10 |
| 1356907356 | Andrew Garton | Student in an Organized Health Care Education/Training Program | New York Weill Cornell Medical Center, 525 E 68th St, New York, NY 10065 | 2019-05-15 |
| 1104481845 | Rana Abualsaud | Student in an Organized Health Care Education/Training Program | New York Presbyterian Hospital, 525 E 68th St, Room M130, New York City, NY 10065 | 2019-05-08 |
| Find all providers in zip 10065 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639720451 | Christophe Cloutier Lambert | Radiology | 1233 York Ave Apt 6m, New York, NY 10065-6342 | 2019-09-23 |
| 1437702727 | Pamela Ines Causa Andrieu | Radiology | 1233 York Ave Apt 19l, New York, NY 10065-6342 | 2019-07-16 |
| 1689231235 | Midtown Diagnostic Group, Inc | Radiology | 353 W 48th St Ste 450, New York, NY 10036-1324 | 2019-05-20 |
| 1659841013 | Midtown West Radiology P.C. | Radiology | 35 Seacoast Terrace, #20n, New York, NY 11235 | 2018-11-28 |
| 1407380272 | Joseph Charles Herring | Radiology | 506 Lenox Ave # Mlk6201, New York, NY 10037-1802 | 2017-04-18 |
| 1639542939 | Kolb Radiology P.C. | Radiology | 307 E 60th St, New York, NY 10022-1505 | 2015-11-09 |
| 1346645652 | Srm Radiology Associates PC | Radiology | 639 W End Ave, #pha, New York, NY 10025-7343 | 2014-10-29 |
| 1366882425 | Christopher John Burke | Radiology | 545 1st Ave # Gbhc124, New York, NY 10016-6401 | 2013-07-03 |
| 1356784490 | Jeffrey Michael Gnerre | Radiology | 150 E 42nd St Fl 4, New York, NY 10017 | 2013-04-08 |
| 1205179686 | James Bai | Radiology | 660 1st Ave Fl 1, New York, NY 10016-3295 | 2013-04-03 |
| Find all providers in NEW YORK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.