Individual
DR. JARROD LAWRENCE BAGATELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
115 FAIRGROUNDS DRIVE, MANLIUS, NY 13104
(315) 682-6165
(315) 682-7929
Mailing address
115 FAIRGROUNDS DRIVE, MANLIUS, NY 13104
(315) 682-6165
(315) 682-7929
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1979451
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01690422
—
NY
Enumeration date
08/20/2006
Last updated
11/15/2010
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