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1861179665
FREDERICK WILLIAM WAGNER
SETAUKET, NY
NPI
1861179665
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
(Licence: NY 2512521)
Enumeration Date
2023-07-03
Last Update Date
2023-07-03
Business Address
Ms. FREDERICK WILLIAM WAGNER MEd
19 JONES ST
SETAUKET, NY 11733-2914
Phone number: 929-483-7383
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Mailing Address
Ms. FREDERICK WILLIAM WAGNER MEd
19 JONES ST
SETAUKET, NY 11733-2914
Phone number: 929-483-7383
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