MR. JEFFREY DOUGLAS WAGNER (NPI# 1891744967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891744967 |
| Entity Type | Individual |
| Full Name | MR. JEFFREY DOUGLAS WAGNER |
| Credential | PA |
| Practice Address |
18 Ronald Ln Sayville NY 11782-1622 |
| Practice Telephone | 6317503924 |
| Mailing Telephone | 6317503924 |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881151876 | Jeffrey Frank Wagner | Pharmacist | 6310 Health Park Way Ste 130, Lakewood Ranch, FL 34202-5177 | 2019-02-26 |
| 1760521843 | Jeffrey M Wagner | Psychologist | 500 Market Street 1-g, Portsmouth, NH 03801 | 2007-02-06 |
| 1437244050 | Jeffrey Todd Wagner | Physical Therapist | 1 Gateway Drive, Wading River, NY 11792 | 2006-10-03 |
| 1881684207 | Jeffrey M Wagner | Allergy & Immunology | 98 Willow Ln, Spartanburg, SC 29307-1357 | 2005-10-26 |
| 1881690790 | Jeffrey David Wagner | Surgery | 8040 Clearvista Pkwy, Ste 570, Indianapolis, IN 46256 | 2005-06-24 |
| 1255894481 | Jeffrey Ryan Wagner | Student in an Organized Health Care Education/Training Program | 2425 Geary Blvd, San Francisco, CA 94115-3358 | 2019-04-14 |
| 1003312117 | Jeffrey Wagner | Clinical Exercise Physiologist | 3525 E Louise Dr, Meridian, ID 83642-6302 | 2018-04-05 |
| 1023552114 | Jeffrey David Wagner | Nurse Practitioner | 3303 Sw Bond Ave, Portland, OR 97239 | 2016-12-08 |
| 1578798914 | Jeffrey Mark Wagner | Physical Therapist | 1430 Esplanade, Suite 8, Chico, CA 95926-3366 | 2009-05-28 |
| 1568624187 | Jeffrey G Wagner | Family Medicine | 9280 W Sunset Rd Ste 200, Las Vegas, NV 89148 | 2008-06-25 |
| Street Address |
18 RONALD LN |
| City | SAYVILLE |
| State | NY |
| Zip Code | 11782-1622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013473545 | Bv Sayville Operator, LLC | Alzheimer Center (Dementia Center) | 445 Broadway Avenue, Sayville, NY 11782 | 2019-02-20 |
| 1174005862 | Wholehearted Living Lcsw PC | Social Worker | 23 Candee Avenue, Sayville, NY 11782 | 2018-08-30 |
| 1134659386 | Sayville Medical and Rehab PC | Physical Medicine & Rehabilitation | 160 Middle Rd Ste 1, Sayville, NY 11782 | 2017-06-19 |
| 1316486806 | Nadine Wilches | Social Worker | 196 N Main St Fl 2, Sayville, NY 11782 | 2017-02-16 |
| 1073922894 | Julia Soldano | Lactation Consultant, Non-RN | 4 Rose Street, Sayville, NY 11782 | 2014-08-06 |
| 1073862314 | Evelyn Weiss | Occupational Therapist | 1401 Ocean Avenue, Apt.5k, Brooklyn, NY 11782 | 2012-08-31 |
| 1972868305 | Kristen M Russo | Specialist | 272 Sayville Boulevard, Sayville, NY 11782 | 2012-07-11 |
| 1669752457 | William Hughes | Registered Nurse | 21 Wedgewood Dr, Coram, NY 11782 | 2011-08-24 |
| 1366741803 | Linda Ann Butelli | Social Worker | 233 Greeley Ave, Sayville, NY 11782 | 2011-03-23 |
| 1376864173 | Peter B. Cinelli | Plastic Surgery | 244 Foster Ave, Sayville, NY 11782 | 2010-06-15 |
| Find all providers in zip 11782 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487252581 | North Shore Medical Group Pllc | Physician Assistant | 311 Skyview Ter, Syracuse, NY 13219-2835 | 2020-10-12 |
| 1477169654 | Kristen Ariel O'connell | Physician Assistant | 85 John St Apt 7a, New York, NY 10038-2844 | 2020-09-22 |
| 1699381616 | David Nmn Kao | Physician Assistant | 737 Pleasant Avenue, Westbury, NY 11590-6407 | 2020-09-16 |
| 1043824816 | Elizabeth Keane | Physician Assistant | 25 Hollis Dr, Sound Beach, NY 11789-1629 | 2020-08-31 |
| 1497364111 | Tianna Stephens | Physician Assistant | 165 N Village Ave Ste 5, Rockville Centre, NY 11570-3701 | 2020-07-28 |
| 1124636188 | Shannon Maureen O'connell | Physician Assistant | 270-05 270th Ave, New Hyde Park, NY 11040 | 2020-07-16 |
| 1841818895 | Yanick Dugue | Physician Assistant | 4 Lincoln Ave, New Hyde Park, NY 11040-3125 | 2020-07-07 |
| 1194340505 | Kayleigh Marie Tourt | Physician Assistant | 222 Alexander St Fl 4, Rochester, NY 14607-4039 | 2020-06-11 |
| 1023638509 | Kristina Rajic | Physician Assistant | 7237 66th Dr, Flushing, NY 11379-2111 | 2020-04-24 |
| 1114547791 | Michele Hein | Physician Assistant | 700 Veterans Memorial Hwy, Hauppauge, NY 11788-2952 | 2020-04-23 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MR. JEFFREY DOUGLAS 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.