Most Relevant Information
Provider Data
| NPI Number: | 1003653882 |
| Provider Name: | HARRY S VANWAGENEN PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 2084N0400X |
| Specialty: | Psychiatry & Neurology |
| License Number: | 25MP00860600 |
Most Important Dates
| Enumeration Date: | 07/10/2024 |
| Last Updated: | 07/10/2024 |
Provider Practice Location
94 OLD SHORT HILLS RD
LIVINGSTON
NJ
070395672
Practice Location Phone/Fax
| Phone: | 9733225000 |
| Fax: |
Provider Mailing Location
811 BRADLEY RD
POINT PLEASANT BORO
NJ
087422324
Provider Mailing Phone/Fax
| Phone: | 7326641603 |
| Fax: |
Suggested EMR
Neurology EMR