National Provider Identifier
Joelle Susan Wagner, PA
Joelle Susan Wagner, PA is listed in the NPPES registry with a primary specialty of Surgical Physician Assistant in West Seneca, NY and a listed phone number of (716) 361-1624.
Profile Overview
- NPI
- 1750858981
- Provider Type
- Individual
- Primary Specialty
- Surgical Physician Assistant
- Enumeration Date
- October 25, 2018
- Last Updated
- December 09, 2020
Practice Location
- 767 Main Street
- West Seneca, NY 14224
Phone: (716) 361-1624
Specialties
- Surgical Physician Assistant (363AS0400X)
- Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1750858981
- Entity Type
- Individual
- Last Name
- Wagner
- First Name
- Joelle
- Middle Name
- Susan
- Name Prefix
- Miss
- Credential
- PA
- Mailing Street Address
- 767 Main Street
- Mailing City
- West Seneca
- Mailing State
- NY
- Mailing ZIP Code
- 14224
- Mailing Country
- US
- Mailing Phone
- (716) 361-1624
- Practice Street Address
- 767 Main Street
- Practice City
- West Seneca
- Practice State
- NY
- Practice ZIP Code
- 14224
- Practice Country
- US
- Practice Phone
- (716) 361-1624
- Enumeration Date
- October 25, 2018
- Last Updated
- December 09, 2020
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- December 09, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Surgical Physician Assistant (363AS0400X), Student in an Organized Health Care Education/Training Program (390200000X)