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NPI Code Detail

MEDICARE: WAGDY GHALY M.D.

MEDICARE: WAGDY GHALY M.D.
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
1207L00000XAnesthesiology Physician134392NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285600544
Entity Type Code : Individual
Provider Name (Legal Business Name) : WAGDY GHALY M.D.
Provider Business Mailing Address
First Line : 534 MAIN ST
Second Line : STE 14
City : MEDINA
State : NY
Zip : 14103-1436
Country : US
Telephone Number : 585-798-3992
Fax Number : 585-798-3865
Provider Business Practice Location Address
First Line : 200 OHIO ST
Second Line :
City : MEDINA
State : NY
Zip : 14103-1063
Country : US
Telephone Number : 585-798-3992
Fax Number : 585-798-3865
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2006
Last Update Date : 07/08/2007

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