Individual
DR. ALAN WAGNER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
33-57 HARRISON ST, JOHNSON CITY, NY 13790
(607) 763-6104
Mailing address
2555 PONCE DE LEON BLVD, 4TH FLOOR, CORAL GABLES, FL 33134
(305) 702-5683
(305) 441-2144
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
131339
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00715655
—
NY
Enumeration date
03/08/2006
Last updated
07/08/2007
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