What is Amanda Wagerik-fasano's NPI number?

The NPI number assigned to this healthcare provider is 1750659215, enumerated as a individual on December 12, 2011.

Where is the provider located?

The provider is located at 3911 RICHMOND AVE STATEN ISLAND, NY 10312 and the phone number is (718) 948-3232.

What is the provider's specialty?

The provider's specialty is Specialist with taxonomy code 174400000X.

MS. AMANDA WAGERIK-FASANO LMSW, CASAC-T - NPI 1750659215

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About Ms. Amanda Wagerik-fasano Lmsw, Casac-t NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. AMANDA WAGERIK-FASANO LMSW, CASAC-T (NPI 1750659215) is an individual specialist in Staten Island, New York and active in the NPI registry since December 2011.

NPPES Registry Identity

NPI1750659215

Entity TypeIndividualFemale

Primary Taxonomy174400000X

Provider Legal NameMS. AMANDA WAGERIK-FASANOCredential: LMSW, CASAC-T

Location Address3911 RICHMOND AVEStaten Island, NY 10312-5110

Mailing Address3911 Richmond AveStaten Island, NY 10312-5110 · (718) 948-3232 · Fax (718) 966-6605

Phone(718) 948-3232

Fax(718) 966-6605

Sole ProprietorYes

Enumeration DateDecember 12, 2011

Last NPPES UpdateMay 8, 2019

✔ NPI 1750659215 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

3911 RICHMOND AVE, Staten Island, NY 10312

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Other Names 1

Former Name (1)Ms. Amanda Cruz

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP