Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VX0201X | Gynecologic Oncologist | 228184 | NY |
Y | 207VX0201X | Gynecologic Oncologist | 25MA07628100 | NJ |
NPI | 1083855332 |
---|---|
Provider Name | Allison R Wagreich |
First Address | Boston, MA 02241-6457 |
Second Address | Morristown, NJ 07960-6136 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2009 |
Last Update Date | 01/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0009946 | (05) | NJ |
161814U77 | MEDICARE PART B (01) | NJ |