Provider Demographics
NPI:1841261534
Name:WARGO, HEATHER C (MD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:C
Last Name:WARGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:HEATHER
Other - Middle Name:C
Other - Last Name:SELMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1 DIAMOND HILL RD
Mailing Address - Street 2:
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-2104
Mailing Address - Country:US
Mailing Address - Phone:908-273-4300
Mailing Address - Fax:
Practice Address - Street 1:911 SUNSET RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-2250
Practice Address - Country:US
Practice Address - Phone:877-388-2778
Practice Address - Fax:856-352-1100
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07301900208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2039855000OtherAMERIHEALTH
2635895OtherAETNA
2635895OtherAETNA
050908AURMedicare ID - Type Unspecified