Individual
DR. RUDOLPH STEVEN WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
288 MILLBURN AVE, MILLBURN, NJ 07041-1622
(973) 912-9199
(973) 912-0800
Mailing address
288 MILLBURN AVE, MILLBURN, NJ 07041-1622
(973) 912-9199
(973) 912-0800
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
25MA03649700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3070107
—
NJ
05
—
3070107-01
—
NJ
Enumeration date
06/12/2006
Last updated
04/21/2022
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