Individual provider · Type 1 NPI
Carolyn M. Wagner, RPA-C
Surgical Physician Assistant · Rochester, NY
NPI number
1679705941
Active
Practice location
1425 Portland Ave
Rochester, NY 14621-3001
Mailing address
100 Kings Hwy S
Rochester, NY 14617-5504
Other practice locations
- 1200 Driving Park Ave, Newark, NY 14513-1090 · (315) 789-5061
- 1200 Driving Park Ave Ste 4, Newark, NY 14513-1090 · (315) 359-2696
- 401 S Main St, Canandaigua, NY 14424-2126 · (585) 412-6491
- 875 Pre Emption Rd, Geneva, NY 14456-2042 · (315) 789-5061
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | 013447 (NY) |
Surgical Physician Assistant: Definition to come...
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About NPI 1679705941
Carolyn M. Wagner, RPA-C's National Provider Identifier is 1679705941, issued on Aug 19, 2009. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Rochester, NY. The record was last updated on May 11, 2021.