Organization
JEROME E. BAGNER, DPM, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEROME E BAGNER DPM (PRESIDENT)
(516) 764-6800
Entity
Organization
Contact information
Practice address
30 HEMPSTEAD AVE, SUITE 158, ROCKVILLE CENTRE, NY 11570-4033
(516) 764-6800
(516) 764-7047
Mailing address
30 HEMPSTEAD AVE, SUITE 158, ROCKVILLE CENTRE, NY 11570-4033
(516) 764-6800
(516) 764-7047
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
N002233-1
NY
Other
Enumeration date
11/09/2012
Last updated
11/09/2012
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