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Individual
DR. WILLIAM ROBERT WAGNER
Active
Individual
DR. WILLIAM ROBERT WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DRNP, LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
R055430
NY
163W00000X
Registered Nurse
541137
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F304782
NY
363LG0600X
Gerontology Nurse Practitioner
F340615
NY
Other
Enumeration date
07/18/2005
Last updated
04/29/2016
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