Individual
DR. JEROME EDWARD BAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
30 HEMPSTEAD AVE, STE 158, ROCKVILLE CENTRE, NY 11570-4033
(516) 764-6800
(516) 764-7047
Mailing address
30 HEMPSTEAD AVE, STE 158, ROCKVILLE CENTRE, NY 11570-4033
(516) 764-6800
(516) 764-7047
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0022331
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00405023
—
NY
Enumeration date
01/04/2006
Last updated
10/16/2013
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