Individual
ALLISON VANWAGENEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
33 MITCHELL AVE, BINGHAMTON, NY 13903-1642
(076) 762-3281
(607) 762-3295
Mailing address
33 LEWIS RD, FL 2, BINGHAMTON, NY 13905
(607) 770-0025
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
751874
NY
363LF0000X
Family Nurse Practitioner
Primary
352297
NY
Other
Enumeration date
07/11/2023
Last updated
09/07/2023
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