Individual
DR. JOHN D WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MBA
Contact information
Practice address
451 CLARKSON AVE RM B-1147, KINGS COUNTY HOSPITAL CENTER, BROOKLYN, NY 11203-2054
(718) 245-3921
(718) 245-5347
Mailing address
451 CLARKSON AVE RM B-1147, KINGS COUNTY HOSPITAL CENTER, BROOKLYN, NY 11203-2054
(718) 245-3921
(718) 245-5347
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
140277
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00837072
—
NY
Enumeration date
01/19/2007
Last updated
03/23/2014
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