Individual
MS. SUSAN J WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COMMUNITY HEALTH WOR
Contact information
Practice address
278 JOHN TUTTLE RD, NEW KINGSTON, NY 12459
(845) 586-4194
Mailing address
BOX 130, NEW KINGSTON, NY 12459
(845) 586-4194
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
05/15/2009
Last updated
05/15/2009
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