Individual
DR. KATHERINE M WAGNER-REISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2800 MAIN ST, ST. VINCENT'S MEDICAL CENTER, DEPT. OF PATHOLOGY, BRIDGEPORT, CT 06606-4201
(203) 576-5033
Mailing address
2800 MAIN ST, ST. VINCENT'S MEDICAL CENTER, DEPT. OF PATHOLOGY, BRIDGEPORT, CT 06606-4201
(203) 576-5033
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
Primary
025577
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001255779
—
CT
Enumeration date
04/17/2006
Last updated
03/10/2010
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