Individual
MRS. SHARA WAGOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
525 E 68TH ST, BOX 92, NEW YORK, NY 10065-4870
(212) 759-6999
Mailing address
525 E 68TH ST, BOX 92, NEW YORK, NY 10065-4870
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
09/01/2010
Last updated
08/22/2014
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