Individual
DR. GABRIEL MICHAEL WAGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1916 UNION BLVD, BAY SHORE, NY 11706-7921
(631) 666-2290
(631) 647-5299
Mailing address
1916 UNION BLVD, BAY SHORE, NY 11706-7921
(631) 666-2290
(631) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
207RA0002X
Adult Congenital Heart Disease Physician
255002
NY
207RC0000X
Cardiovascular Disease Physician
Primary
255002
NY
207RH0005X
Hypertension Specialist Physician
255002
NY
207UN0902X
Nuclear Imaging & Therapy Physician
255002
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03166589
—
NY
Enumeration date
10/14/2009
Last updated
11/16/2018
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