DR. ALAN WAGNER (NPI# 1649248584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649248584 |
| Entity Type | Individual |
| Full Name | DR. ALAN WAGNER |
| Credential | MD |
| Practice Address |
33-57 Harrison St Johnson City NY 13790 |
| Mailing Address |
2555 Ponce De Leon Blvd 4th Floor Coral Gables FL 33134 |
| Practice Telephone | 6077636104 |
| Mailing Telephone | 3057025683 |
| Mailing Fax Number | 3054412144 |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
131339 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00715655 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295719631 | Alan Lewis Wagner | Ophthalmology | 6160 Kempsville Cir Ste 120b, Norfolk, VA 23502-3933 | 2005-11-30 |
| 1811597792 | Alan Wagner | Private Vehicle | 795 S Township Road 113, Tiffin, OH 44883-9791 | 2020-10-29 |
| 1104372416 | Alan Wagner | Pharmacist | 2253 N Richmond Rd, Mchenry, IL 60051-5401 | 2016-08-27 |
| 1497701684 | Alan S. Wagner | Radiology | 3849 N Perryville Rd, Rockford, IL 61114-8080 | 2006-05-26 |
| 1164406674 | Alan Marvin Wagner | Obstetrics & Gynecology | 1024 Main St, Woodward, OK 73801-3120 | 2005-11-30 |
| 1881686244 | Alan Duane Wagner | Nurse Anesthetist, Certified Registered | 405 W Jackson St, Carbondale, IL 62901-1462 | 2005-08-22 |
| Street Address |
33-57 HARRISON ST |
| City | JOHNSON CITY |
| State | NY |
| Zip Code | 13790 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669477832 | Rajesh Jayantkrishna Dave | Specialist | 33-57 Harrison St, Johnson City, NY 13790-2143 | 2005-06-15 |
| 1447851944 | Sagarkumar Patel | Nurse Practitioner | 33-57 Harrison St, Johnson City, NY 13790-2107 | 2020-11-03 |
| 1083214332 | Justin Michael Eisenhauer | Physician Assistant | 33-57 Harrison St, Johnson City, NY 13790-2107 | 2020-10-27 |
| 1124665849 | Jason D Oziemina | Physical Therapist | 33-57 Harrison St, Johnson City, NY 13790-2107 | 2019-12-02 |
| 1104462472 | Cathy J Forde | Occupational Therapist | 33-57 Harrison St, Johnson City, NY 13790-2107 | 2019-11-21 |
| 1740826361 | Marie Beth Abell | Physical Medicine & Rehabilitation | 33-57 Harrison St, Johnson City, NY 13790-2107 | 2019-11-19 |
| 1841835675 | Jessica Lynn Mclaughlin | Occupational Therapist | 33-57 Harrison St, Johnson City, NY 13790-2107 | 2019-11-15 |
| 1346885399 | Brianna Bruster | Speech-Language Pathologist | 33-57 Harrison St, Johnson City, NY 13790-2107 | 2019-11-14 |
| 1689219735 | Jinfang Li | Physician Assistant | 33-57 Harrison St, Johnson City, NY 13790-2107 | 2019-11-13 |
| 1437794781 | John Yacano | Physician Assistant | 33-57 Harrison St, Johnson City, NY 13790-2107 | 2019-11-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578107645 | Thomas William Sorber | Occupational Therapist | 33 Harrison St, Johnson City, Johnson City, NY 13790 | 2019-11-01 |
| 1326534116 | Silver Linings Golden Memory Care | Clinic/Center | 4416 Watson Blvd, Johnson City, NY 13790 | 2018-07-05 |
| 1508308545 | Irene Mukeli Nzasi | Registered Nurse | 156 Corliss Ave Suite 107, Johnson City, NY 13790 | 2016-11-08 |
| 1053867754 | Tabitha Rae Toman | Physical Therapist | 34 Harrison St, Johnson City, NY 13790 | 2016-09-01 |
| 1235685066 | Dianne Brunner | Physical Therapist | 33-55 Harrison Street, Wilson Hospital, Johnson City, NY 13790 | 2016-08-31 |
| 1578982682 | Tracy Lynn Brown | Optometrist | 223 Reynolds Road, Johnson City, NY 13790 | 2014-04-16 |
| 1083041495 | Maryann Serbonich | Pharmacist | 52 Harrison Street, Johnson City, NY 13790 | 2013-09-30 |
| 1134464399 | Kasey Connor Folger | Speech-Language Pathologist | 3 Laurel St., Johnson City, NY 13790 | 2012-11-29 |
| 1467797571 | Bodyworks Physical Therapy LLC | Clinic/Center | 765 Harry L Drive, Johnson City, NY 13790 | 2012-11-29 |
| 1548518400 | Melissa L Korosec | Nurse Practitioner | 30 Harrison St., Suite 250, Johnson City, NY 13790 | 2012-08-27 |
| Find all providers in zip 13790 | ||||
| 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 |
|---|---|---|---|---|
| 1811212319 | David R Clopton | Radiology | 208 Highland Ridge Ter, Johnson City, TN 37615-4499 | 2010-03-29 |
| 1114945292 | Vinay Jain | Radiology | James H Quillen Vamc, Mountain Home, Johnson City, TN 37684 | 2006-07-17 |
| 1205872017 | Razvan Florin Buciuc | Radiology | 30 Harrison St Ste 400, Johnson City, NY 13790-2176 | 2006-06-21 |
| 1184682494 | Vincent Gerard Becker | Radiology | 1301 Sunset Dr, Ste 3, Johnson City, TN 37604-7906 | 2006-05-03 |
| 1952379893 | John Brunson | Radiology | 3357 Harrison Street, Johnson City, NY 13790 | 2006-03-08 |
| 1902873219 | Anwer Puthawala | Radiology | 33-57 Harrison Street, Johnson City, NY 13790 | 2006-03-06 |
| 1386629079 | Edward Sterling Rollins | Radiology | 167 Anderson Rd, Johnson City, TN 37601-5334 | 2005-12-14 |
| 1780669861 | Sundar Jayaraman | Radiology | 32-36 Harrison St, Johnson City, NY 13790-2122 | 2005-12-12 |
| 1346248028 | Brian Mason | Radiology | 410 N State of Franklin Rd, Suite 135b, Johnson City, TN 37604-6971 | 2005-07-07 |
| 1366447401 | Scott G Akin | Radiology | 208 Sunset Dr Ste 370, Johnson City, TN 37604 | 2005-06-16 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 13790 |
Please comment or provide details below to improve the information on DR. ALAN WAGNER.
| 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.