Individual
DR. JEFFREY B WANERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
333 BROADWAY, AMITYVILLE, NY 11701-2719
(631) 789-3999
(631) 789-0809
Mailing address
333 BROADWAY, AMITYVILLE, NY 11701-2719
(631) 789-3999
(631) 789-0809
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
164953
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01384207
—
NY
Enumeration date
09/26/2006
Last updated
07/08/2007
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