Individual
MRS. MADLEN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
379 W 127TH ST APT 32, NEW YORK, NY 10027-3529
(646) 248-0897
Mailing address
379 W 127TH ST APT 32, NEW YORK, NY 10027-3529
(646) 248-0897
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
006904-01
NY
225700000X
Massage Therapist
026284-01
NY
Other
Enumeration date
03/24/2021
Last updated
03/24/2021
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