Provider Demographics
NPI:1699936443
Name:NUGENT, WADICAR FABIAN (MD)
Entity type:Individual
Prefix:MR
First Name:WADICAR
Middle Name:FABIAN
Last Name:NUGENT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 HEMPSTEAD TURNPIKE
Mailing Address - Street 2:DEPARTMENT OF PATHOLOGY
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554
Mailing Address - Country:US
Mailing Address - Phone:516-572-3202
Mailing Address - Fax:516-572-8894
Practice Address - Street 1:2201 HEMPSTEAD TURNPIKE
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554
Practice Address - Country:US
Practice Address - Phone:516-572-3202
Practice Address - Fax:516-572-8894
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program