| John Raymond Wagner, MD | |
|
7 Pulaski Rd, East Northport, NY 11731-2442 | |
| (631) 261-3322 | |
| (631) 368-5440 |
| Full Name | John Raymond Wagner |
|---|---|
| Gender | Male |
| Speciality | Obstetrics/gynecology |
| Experience | 39 Years |
| Location | 7 Pulaski Rd, East Northport, New York |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538120704 | NPI | - | NPPES |
| 01280253 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | 181212 (New York) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ns/lij Hs Huntington Hospital | Huntington, NY | Hospital |
| North Shore University Hospital | Manhasset, NY | Hospital |
| Good Samaritan Hospital Medical Center | West islip, NY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| North Shore-lij Medical Pc | 3375701568 | 6327 |
| Entity Name | North Shore-lij Medical Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053688572 PECOS PAC ID: 3375701568 Enrollment ID: O20120220000262 |
| Mailing Address | Practice Location Address |
|---|---|
| John Raymond Wagner, MD 7 Pulaski Rd, East Northport, NY 11731-2442 Ph: (631) 261-3322 | John Raymond Wagner, MD 7 Pulaski Rd, East Northport, NY 11731-2442 Ph: (631) 261-3322 |
Martin I Granoff, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 554 Larkfield Rd, East Northport, NY 11731 Phone: 631-368-3800 | |
Theodore Lyle Goldman, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 7 Pulaski Rd, East Northport, NY 11731 Phone: 631-261-3322 Fax: 631-368-5440 |