# JEFFREY WANERMAN MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740638345
- **Authorized official:** DR. JEFFREY WANERMAN MD (OWNER)
- **Authorized official phone:** (631) 835-5367

## Contact information

- **Practice address:** 301 E MAIN ST, BAY SHORE, NY 11706-8408
- **Practice address phone:** (631) 835-5367
- **Mailing address:** 514 MAGNOLIA LN, DIX HILLS, NY 11746-7710
- **Mailing address phone:** (631) 835-5367

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 164953 | NY | Yes |

## Other

- **Enumeration date:** 05/25/2016
- **Last updated:** 05/25/2016