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1134604648
JESSICA WAGNER
BROOKLYN, NY
NPI
1134604648
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
163W00000X Registered Nurse
(Licence: NY 578558)
Enumeration Date
2018-10-01
Last Update Date
2018-10-01
Business Address
JESSICA WAGNER
4802 10TH AVE
BROOKLYN, NY 11219-2916
Phone number: 718-283-3071
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Mailing Address
JESSICA WAGNER
97 HARRIS LN
STATEN ISLAND, NY 10309-1505
Phone number:
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