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Individual

DR. PHILIP J WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
535 E 70TH ST, HSS DEPT. OF ANESTHESIOLOGY, NEW YORK, NY 10021-4823
(212) 774-2383
(212) 774-7808
Mailing address
GPO BOX 27578, NEW YORK, NY 10087-7578
(844) 268-4820
(631) 201-3179

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
206778
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01914910
NY
01
206778
STATE LICENSE
NY
01
33977
STATE LICENSE
CT
01
ME139303
STATE LICENSE
FL
Enumeration date
06/20/2006
Last updated
10/23/2024
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