National Provider Identifier
Mary Sophia Wagner
Mary Sophia Wagner is listed in the NPPES registry with a primary specialty of Specialist in Buffalo, NY and a listed phone number of (716) 697-4773.
Profile Overview
- NPI
- 1649916149
- Provider Type
- Individual
- Primary Specialty
- Specialist
- Enumeration Date
- May 07, 2022
- Last Updated
- May 07, 2022
Practice Location
- 212 Metcalfe St
- Buffalo, NY 14206-2139
Phone: (716) 697-4773
Specialties
- Specialist (174400000X)
Full Record
- NPI
- 1649916149
- Entity Type
- Individual
- Last Name
- Wagner
- First Name
- Mary
- Middle Name
- Sophia
- Mailing Street Address
- 212 Metcalfe St
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14206-2139
- Mailing Country
- US
- Mailing Phone
- (716) 697-4773
- Practice Street Address
- 212 Metcalfe St
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14206-2139
- Practice Country
- US
- Practice Phone
- (716) 697-4773
- Enumeration Date
- May 07, 2022
- Last Updated
- May 07, 2022
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- May 07, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Specialist (174400000X)