Krystn R Wagner (NPI# 1669455127, PAC ID# 0840260527) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INFECTIOUS DISEASE.
| Nation Provider ID (NPI) | 1669455127 |
| PAC ID by PECOS | 0840260527 |
| Professional Enrollment ID | I20040729000718 |
| Full Name | Krystn R Wagner |
| Organization Legal Name | FAIR HAVEN COMMUNITY HEALTH CLINIC INC |
| Address |
374 Grand Ave New Haven CT 06513-3733 |
| Phone Number | 2037777411 |
| Gender | F |
| Credential | MD |
| Medical School | YALE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1996 |
| Primary Specialty | INFECTIOUS DISEASE |
| Group Practice PAC ID | 4183511538 |
| Number of Group Practice Members | 31 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 070022 | YALE-NEW HAVEN HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 374 Grand Ave, New Haven, CT 06513-3733 | 2037777411 | FAIR HAVEN COMMUNITY HEALTH CLINIC INC |
| Organization Legal Name | FAIR HAVEN COMMUNITY HEALTH CLINIC INC |
| Physicians | 30 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher O Phillips | Internal Medicine | Fair Haven Community Health Clinic Inc | 374 Grand Ave, New Haven, CT 06513-3733 |
| Leif Eric Petterson | Nurse Practitioner | Fair Haven Community Health Clinic Inc | 426 E St, New Haven, CT 06511-5018 |
| Anne W Camp | Internal Medicine | Fair Haven Community Health Clinic Inc | 339 Eastern St, Bldg B, New Haven, CT 06513-2463 |
| John C Mcdonagh | Emergency Medicine | Fair Haven Community Health Clinic Inc | 370 Hemingway Ave, East Haven, CT 06512-3240 |
| Ellen J Wormser | Certified Nurse Midwife (cnm) | Fair Haven Community Health Clinic Inc | 374 Grand Ave, New Haven, CT 06513-3733 |
| Kyle T Elligers | Family Medicine | Fair Haven Community Health Clinic Inc | 374 Grand Ave, New Haven, CT 06513-3733 |
| Elizabeth A Magenheimer | Nurse Practitioner | Fair Haven Community Health Clinic Inc | 374 Grand Ave, New Haven, CT 06513-3733 |
| Damaris Rodriguez | Clinical Social Worker | Fair Haven Community Health Clinic Inc | 374 Grand Ave, New Haven, CT 06513-3733 |
| Priscilla A Jencks | Certified Nurse Midwife (cnm) | Fair Haven Community Health Clinic Inc | 374 Grand Ave, New Haven, CT 06513-3733 |
| Oni A Muhammad | Certified Nurse Midwife (cnm) | Fair Haven Community Health Clinic Inc | 374 Grand Ave, New Haven, CT 06513-3733 |
| Street Address |
374 GRAND AVE |
| City | NEW HAVEN |
| State | CT |
| Zip | 06513-3733 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher O Phillips | Internal Medicine | Fair Haven Community Health Clinic Inc | 374 Grand Ave, New Haven, CT 06513-3733 |
| Ellen J Wormser | Certified Nurse Midwife (cnm) | Fair Haven Community Health Clinic Inc | 374 Grand Ave, New Haven, CT 06513-3733 |
| Kyle T Elligers | Family Medicine | Fair Haven Community Health Clinic Inc | 374 Grand Ave, New Haven, CT 06513-3733 |
| Elizabeth A Magenheimer | Nurse Practitioner | Fair Haven Community Health Clinic Inc | 374 Grand Ave, New Haven, CT 06513-3733 |
| Damaris Rodriguez | Clinical Social Worker | Fair Haven Community Health Clinic Inc | 374 Grand Ave, New Haven, CT 06513-3733 |
| Priscilla A Jencks | Certified Nurse Midwife (cnm) | Fair Haven Community Health Clinic Inc | 374 Grand Ave, New Haven, CT 06513-3733 |
| Oni A Muhammad | Certified Nurse Midwife (cnm) | Fair Haven Community Health Clinic Inc | 374 Grand Ave, New Haven, CT 06513-3733 |
| Mellisa Pensa | Preventative Medicine | Fair Haven Community Health Clinic Inc | 374 Grand Ave, New Haven, CT 06513-3733 |
| Jennifer B Yaro | Nurse Practitioner | Fair Haven Community Health Clinic Inc | 374 Grand Ave, New Haven, CT 06513-3733 |
| Leslie Dimella | Psychiatry | Fair Haven Community Health Clinic Inc | 374 Grand Ave, New Haven, CT 06513-3733 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Timothy J Leffert | Chiropractic | 847 Foxon Rd, East Haven, CT 06513-1834 | |
| Anne W Camp | Internal Medicine | Fair Haven Community Health Clinic Inc | 339 Eastern St, Bldg B, New Haven, CT 06513-2463 |
| Elizabeth M Roessler | Physician Assistant | Fair Haven Community Health Clinic Inc | 339 Eastern St, Bldg B, New Haven, CT 06513-2463 |
| Brian M Padilla | Psychologist, Clinical | Fair Haven Community Health Clinic Inc | 339 Eastern St, Bldg B, New Haven, CT 06513-2463 |
| Douglas P Olson | Internal Medicine | Fair Haven Community Health Clinic Inc | 339 Eastern St, Bldg B, New Haven, CT 06513-2463 |
| Christine Anne Blatchley | Clinical Social Worker | Catholic Charities Inc Archdiocese of Hartford | 501 Lombard St, New Haven, CT 06513-2910 |
| Chaundra C Bailey | Clinical Social Worker | 315 Peck St, New Haven, CT 06513-2933 | |
| Eric Goldberg | Internal Medicine | American Current Care Pa | 370 James St, Suite 304, New Haven, CT 06513-3091 |
| Robert T Sadock | Internal Medicine | American Current Care Pa | 370 James St, Suite 304, New Haven, CT 06513-3091 |
| Abigail Ellen Tischler | Clinical Social Worker | 315 Front St, New Haven, CT 06513-3200 | |
| Find all physicians in zip 06513 | |||
| City | NEW HAVEN |
| Zip Code | 06513 |
| Specialty | INFECTIOUS DISEASE |
| City + Specialty | NEW HAVEN + INFECTIOUS DISEASE |
Please comment or provide details below to improve the information on Krystn R Wagner.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.