National Provider Identifier
Timothy Michael Wagner
Timothy Michael Wagner is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program in Buffalo, NY and a listed phone number of (716) 383-4245.
Profile Overview
- NPI
- 1164201646
- Provider Type
- Individual
- Primary Specialty
- Student in an Organized Health Care Education/Training Program
- Enumeration Date
- September 25, 2023
- Last Updated
- September 25, 2023
Practice Location
- 200 Lakefront Blvd
- Buffalo, NY 14202-4355
Phone: (716) 383-4245
Specialties
- Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1164201646
- Entity Type
- Individual
- Last Name
- Wagner
- First Name
- Timothy
- Middle Name
- Michael
- Mailing Street Address
- 200 Lakefront Blvd
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14202-4355
- Mailing Country
- US
- Mailing Phone
- (716) 383-4245
- Practice Street Address
- 200 Lakefront Blvd
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14202-4355
- Practice Country
- US
- Practice Phone
- (716) 383-4245
- Enumeration Date
- September 25, 2023
- Last Updated
- September 25, 2023
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- September 25, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Student in an Organized Health Care Education/Training Program (390200000X)