# DR. WILLIAM ROBERT WAGNER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1043219587
- **Gender:** Man
- **Credential:** DRNP, LCSW

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | R055430 | NY | — |
| 163W00000X | Registered Nurse | 541137 | NY | — |
| 363LA2200X | Adult Health Nurse Practitioner | F304782 | NY | Yes |
| 363LG0600X | Gerontology Nurse Practitioner | F340615 | NY | — |

## Other

- **Enumeration date:** 07/18/2005
- **Last updated:** 04/29/2016