Sharad Wagle, MD

Primary specialty

Psychosomatic Medicine PhysicianTaxonomy code 2084P0015X

License

MA031494 Issued in DC

Practice address

718 Teaneck Rd
Holyname Name Hospital
Teaneck, NJ 07666-4245

Phone

(201) 833-3291

Fax

(201) 541-5962

NPI assigned

Apr 13, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801011283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 GOLF PL",
            "city": "ORADELL",
            "state": "NJ",
            "postal_code": "076491215",
            "telephone_number": "201-262-6522",
            "fax_number": "201-541-5962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 TEANECK RD",
            "address_2": "HOLYNAME NAME HOSPITAL",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664245",
            "telephone_number": "201-833-3291",
            "fax_number": "201-541-5962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGLE",
        "first_name": "SHARAD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "DC",
            "license": "MA031494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dina M Vitorino, LPC
• Melba Vittal, MD
• Allison Vogel, MS, RD
• Ashley Rebecca Voshell, FNP-C
• Lalita Wagle, MD
• Ephrem Wagner, PSYD
• Sari Wagner, DDS
• Nadeem Wain, MD
• Malki Waldman, MS, RD
• Kelsey Waldron, MS, OTR/L

• Psychosomatic Medicine Physician in Teaneck, NJ
• Providers in Teaneck, NJ by specialty
• Psychosomatic Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.