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

Jesse Matthew Wagner

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1437712536

Jesse Matthew Wagner is a Student in an Organized Health Care Education/Training Program in Bronx, New York. Works from 2 locations. Registered with an NPI since 2019.

In the registry since
2019

Practice location Address checks out

111 E 210th St
Bronx, NY 10467-2401
Phone: (516) 851-5770
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 111 E 210th St, Bronx, NY 10467-2401 — (888) 700-6623

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1437712536
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 15, 2019
Last updated in NPPESApril 15, 2019
Mailing address111 E 210th St, Bronx, NY 10467-2401

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