Individual
MEGAN WANNAMAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
703 MAIN ST, PATERSON, NJ 07503-2691
(973) 754-4399
Mailing address
699 KINGSLAND AVE, RIDGEFIELD, NJ 07657-1409
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MB09551900
NJ
Other
Enumeration date
06/08/2012
Last updated
07/02/2018
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