Individual
DR. SURAJI WAGAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3720 SPRUCE ST STE 409, PHILADELPHIA, PA 19104-4115
(844) 287-4228
Mailing address
3720 SPRUCE ST STE 409, PHILADELPHIA, PA 19104-4115
(844) 287-4228
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
025772
NY
103T00000X
Psychologist
Primary
06656
MD
Other
Enumeration date
01/25/2021
Last updated
01/27/2025
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