Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Jack Wagner, MD

Individual provider Surgery Physician · NPI 1578775326

Dr. Jack Wagner, MD is a Surgery Physician in New Rochelle, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

37 Wilputte Pl
New Rochelle, NY 10804-1426
Phone: (914) 636-5678
Fax: (914) 235-0153
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 90773 (NY)

Record details

NPI number1578775326
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMay 4, 2007
Last updated in NPPESJuly 8, 2007

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