Individual
DR. KURT RICHARD WENGERTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25 ROCKWOOD PL, SUITE 330, ENGLEWOOD, NJ 07631-4957
(201) 408-5195
(201) 408-2485
Mailing address
25 ROCKWOOD PL, SUITE 330, ENGLEWOOD, NJ 07631-4957
(201) 408-5195
(201) 408-2485
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
25MA06395000
NJ
2086S0129X
Vascular Surgery Physician
Primary
25MA06395000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01026099
—
NY
01
—
020034631
RAILROAD MEDICARE ID #
NJ
05
—
6984100
—
NJ
Enumeration date
03/22/2006
Last updated
03/12/2017
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