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

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1619303104

Jon-Erik Wagner, MD is a Student in an Organized Health Care Education/Training Program in Johnson City, New York. Registered with an NPI since 2013.

In the registry since
2013
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

40 Arch St
Johnson City, NY 13790-2102
Phone: (607) 763-6075
Fax: (607) 763-5234
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

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

Record details

NPI number1619303104
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 17, 2013
Last updated in NPPESJanuary 21, 2014
Mailing address346 Grand Ave, Johnson City, NY 13790-2580

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