Individual
DR. STEPHEN WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1508 GENESEE ST, UTICA, NY 13502-5178
(315) 798-8737
(315) 732-1702
Mailing address
1508 GENESEE ST, UTICA, NY 13502-5178
(315) 798-8737
(315) 732-1702
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
242667
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03168343
MEDICAID
NY
01
—
RB3864
MEDICARE PTAN
—
Enumeration date
02/07/2007
Last updated
05/22/2013
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