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

Timothy Michael Wagner

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1164201646

Timothy Michael Wagner is a Student in an Organized Health Care Education/Training Program in Buffalo, New York. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

200 Lakefront Blvd
Buffalo, NY 14202-4355
Phone: (716) 383-4245
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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 number1164201646
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 25, 2023
Last updated in NPPESSeptember 25, 2023
Certification dateSeptember 25, 2023
Mailing address200 Lakefront Blvd, Buffalo, NY 14202-4355

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