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General NPI Number Information
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NPI Number | 1740740737
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Entity Type | Organization
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Legal Business Name | WESTERN NEW ENGLAND UNIVERSITY
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Dates
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Enumeration Date | 03/25/2019
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Last Update Date | 03/25/2019
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Provider Practice Location Address
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Address Line | 215 WILBRAHAM ROAD
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City | SPRINGFIELD
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State | MA
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Zip | 01119
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Country | US
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Telephone | 413-782-1211
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Fax | 413-796-2255
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Provider Business Mailing Address
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Address Line | 215 WILBRAHAM ROAD
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City | SPRINGFIELD
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State | MA
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Zip | 01119
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Country | US
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Telephone | 413-782-1211
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Fax | 413-796-2255
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Authorized Official
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Title or Position | VICE PRESIDENT OF FINANCE AND ADMIN
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Name | DR. RICHARD A WAGNER
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Credential | PHD
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Telephone | 413-782-1219
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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