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1871121798
JUSTIN JOHN WAGNER
BROOKLYN, NY
NPI
1871121798
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2020-03-27
Last Update Date
2020-03-27
Business Address
JUSTIN JOHN WAGNER
2601 OCEAN PKWY
BROOKLYN, NY 11235-7745
Phone number: 718-616-3000
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Mailing Address
JUSTIN JOHN WAGNER
2601 OCEAN PKWY
BROOKLYN, NY 11235-7745
Phone number:
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