Active NPI
L. Clifford Vanwagner, RPH
- Pharmacist
- Saratoga Springs, NY
National Provider Identifier
1609192053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 30019
- Practice address
- 131 Lawrence St
Saratoga Springs, NY 12866-1346 - Phone
- (518) 691-1462
- Fax
- (518) 691-1640
- NPI assigned
- Apr 9, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 30019 | NY | Primary |
Addresses
Primary practice location
131 Lawrence St
Saratoga Springs, NY 12866-1346
Mailing address
131 Lawrence St
Saratoga Springs, NY 12866-1346
Phone (518) 691-1462
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30019 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270771200000",
"number": "1609192053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "131 LAWRENCE ST",
"city": "SARATOGA SPRINGS",
"state": "NY",
"postal_code": "128661346",
"telephone_number": "518-691-1462",
"fax_number": "518-691-1640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "131 LAWRENCE ST",
"city": "SARATOGA SPRINGS",
"state": "NY",
"postal_code": "128661346",
"telephone_number": "518-691-1462",
"fax_number": "518-691-1640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANWAGNER",
"first_name": "L.",
"middle_name": "CLIFFORD",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-04-09",
"last_updated": "2010-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "30019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saratoga Springs, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.