National Provider Identifier
Susan Mary Wielgosz, ATC
Susan Mary Wielgosz, ATC is listed in the NPPES registry with a primary specialty of Athletic Trainer in Brockport, NY and a listed phone number of (585) 395-5358.
Profile Overview
- NPI
- 1720018385
- Provider Type
- Individual
- Primary Specialty
- Athletic Trainer
- Enumeration Date
- July 03, 2006
- Last Updated
- July 08, 2007
Practice Location
- 350 New Campus Dr
- Suny College At Brockport
- Brockport, NY 14420-2997
Phone: (585) 395-5358
Mailing Address
- 10 Tearose Meadow Ln
- Brockport, NY 14420-9336
Specialties
- Athletic Trainer (2255A2300X)
Full Record
- NPI
- 1720018385
- Entity Type
- Individual
- Last Name
- Wielgosz
- First Name
- Susan
- Middle Name
- Mary
- Credential
- ATC
- Mailing Street Address
- 10 Tearose Meadow Ln
- Mailing City
- Brockport
- Mailing State
- NY
- Mailing ZIP Code
- 14420-9336
- Mailing Country
- US
- Practice Street Address
- 350 New Campus Dr
- Practice Address Line 2
- Suny College At Brockport
- Practice City
- Brockport
- Practice State
- NY
- Practice ZIP Code
- 14420-2997
- Practice Country
- US
- Practice Phone
- (585) 395-5358
- Enumeration Date
- July 03, 2006
- Last Updated
- July 08, 2007
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Athletic Trainer (2255A2300X)