Individual
MRS. ALEXIS WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RRT
Contact information
Practice address
58 GOTHAM AVE, BROOKLYN, NY 11229-6012
(718) 552-6303
Mailing address
58 GOTHAM AVE, BROOKLYN, NY 11229-6012
(718) 552-6303
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
010860
NY
Other
Enumeration date
03/28/2024
Last updated
03/28/2024
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