Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 013499 | NY |
NPI | 1003582933 |
---|---|
Provider Name | Dr. John Wagdy Nagiub |
First Address | Fort Erie, ONTARIO L2A 0C7 |
Second Address | Orchard Park, NY 14127-1209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2021 |
Last Update Date | 20/08/2021 |