Alfred a. Wagner

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV003310-1 Issued in NY

Legal business name

ALFRED A. WAGNER

Doing business as

Alfred A. Wagner, O.D.

Practice address

8740 State Route 434
Apalachin, NY 13732-4009

Phone

(607) 625-2121

Fax

(607) 625-2131

NPI assigned

Nov 22, 2013

Last updated

Nov 22, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Alfred A. Wagner, O.D. (DOCTOR OF OPTO

Title

Owner/Optometrist

Phone

(607) 625-2121

Specialties & licenses 1

Addresses

Other names 1

• Alfred A. Wagner, O.D. Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385078400000",
    "number": "1245660547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 315",
            "city": "APALACHIN",
            "state": "NY",
            "postal_code": "137324009",
            "telephone_number": "607-625-2121",
            "fax_number": "607-625-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8740 STATE ROUTE 434",
            "city": "APALACHIN",
            "state": "NY",
            "postal_code": "137324009",
            "telephone_number": "607-625-2121",
            "fax_number": "607-625-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALFRED A. WAGNER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-22",
        "last_updated": "2013-11-22",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "607-625-2121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D. (DOCTOR OF OPTO"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV003310-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alfred A. Wagner, O.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Denise Marie Abrams, PT, MA, DPT
• Taoreed Ayinla Adeoshun
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• Apalachin Physical Therapy
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• Carolyn Renee Barnett, MS OTR/L
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• Optometrist in Apalachin, NY
• Providers in Apalachin, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.