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DR. CAROLYN BLAIR WAGNER M.D. NPI 1508210931


NPI Information

NPI: 1508210931
Provider Name: DR. CAROLYN BLAIR WAGNER, M.D.
Classification: Pediatrics - 208000000X
Entity Type: Individual
Organization: URBAN HEALTH PLAN INC

PECOS Registration: Yes

Address:
1065 SOUTHERN BLVD
DEPARTMENT OF PEDIATRICS
BRONX, NY
ZIP 10459
Phone: (718) 589-2440
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DR. Carolyn Blair Wagner, M.D. is a pediatrics in Bronx, NY with 8 years of experience. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DR. Carolyn Blair Wagner, M.D. NPI is 1508210931. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: TEMPLE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2016

The provider's business location address is:

1065 SOUTHERN BLVD
DEPARTMENT OF PEDIATRICS
BRONX, NY
ZIP 10459-417
Phone: (718) 589-2440

The NPI 1508210931 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/22/2016 and was last updated on 7/2/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics299303-1NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.