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JESSE MATTHEW WAGNER
NPI 1437712536
Student in an Organized Health Care Education/Training Program in Bronx, NY

Active since April 15, 2019
111 E 210TH ST, BRONX, NY 10467(516) 851-5770 Get Directions Write a Review

NPPES record last updated: April 15, 2019. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Jesse Matthew Wagner NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESSE MATTHEW WAGNER (NPI 1437712536) is an individual student in an organized health care education/training program in Bronx, New York and active in the NPI registry since April 2019. He maintains a secondary practice location in Bronx.

NPPES Registry Identity

NPI1437712536
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJESSE MATTHEW WAGNER
Location Address111 E 210TH STBronx, NY 10467-2401
Mailing Address111 E 210th StBronx, NY 10467-2401
Phone(516) 851-5770
Sole ProprietorNo
Enumeration DateApril 15, 2019
✔ NPI 1437712536 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
111 E 210TH ST, Bronx, NY 10467
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Secondary Practice Location 1

Location 1111 E 210th StBronx, NY 10467-2401 · Phone (888) 700-6623

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEATHER ROOT MD
Internal Medicine (Infectious Disease)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-8592
MICHAEL GOTTESMAN M.D.
Radiology (Diagnostic Neuroimaging)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-5506
JIAE LEE M.D.
Psychiatry & Neurology (Neurology)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
DR. MICHELLE DOMINIQUE PINTEA MD
Pediatrics
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
TELISHA MCLEAN
Nurse Practitioner (Family)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
SHIVADITYA CHOUDHURY
Anesthesiology
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
MS. JOHANNA SHEA-FEN TAN
Student in an Organized Health Care Education/Training Program
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
JACK DANIEL HALLIGAN MD
Pediatrics
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jesse Wagner's NPI number?

The NPI number for Jesse Wagner is 1437712536. It was assigned to this individual provider in the NPPES registry on April 15, 2019.

Where is Jesse Wagner located?

Jesse Wagner practices at 111 E 210th St, Bronx, NY 10467. The listed phone number is (516) 851-5770.

What is Jesse Wagner's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Jesse Wagner was last updated on April 15, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.