Most Relevant Information
Provider Data
| NPI Number: | 1003398959 |
| Provider Name: | SETH CHRISTOPHER JACOB-WAGNER NP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | F343222-1 |
Most Important Dates
| Enumeration Date: | 09/06/2018 |
| Last Updated: | 01/27/2023 |
Provider Practice Location
114 UNIVERSITY AVE
ROCHESTER
NY
146052992
Practice Location Phone/Fax
| Phone: | 5855462271 |
| Fax: |
Provider Mailing Location
343 HOYT ST UPPR
BUFFALO
NY
142131246
Provider Mailing Phone/Fax
| Phone: | 7164801596 |
| Fax: |