Individual
EMILIE WASSERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4751 N 15TH ST, PHOENIX, AZ 85014-3707
(602) 277-7526
Mailing address
4751 N 15TH ST, PHOENIX, AZ 85014-3707
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
285977
NY
207Q00000X
Family Medicine Physician
Primary
64750
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/19/2013
Last updated
10/14/2021
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