MEDICARE: BENJAMIN YAGER AGACNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	672214-1	NY
2	163WP0200X	Pediatric Registered Nurse	672214-1	NY
3	363LA2100X	Acute Care Nurse Practitioner	433150	NY

General Provider Information

NPI Number	:	1558984328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN YAGER AGACNP

Provider Business Mailing Address
First Line	:	7 LOSO DR APT 706
Second Line	:
City	:	CICERO
State	:	NY
Zip	:	13039-7110
Country	:	US
Telephone Number	:	315-216-8045
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 LOSO DR APT 706
Second Line	:
City	:	CICERO
State	:	NY
Zip	:	13039-7110
Country	:	US
Telephone Number	:	315-216-8045
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2020
Last Update Date	:	04/09/2026

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