Individual
HARRY S VANWAGENEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
94 OLD SHORT HILLS RD, LIVINGSTON, NJ 07039-5672
(973) 322-5000
Mailing address
811 BRADLEY RD, POINT PLEASANT BORO, NJ 08742-2324
(732) 664-1603
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
25MP00860600
NJ
Other
Enumeration date
07/10/2024
Last updated
07/10/2024
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