Molly Wagman

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

020420 Issued in NY

Practice address

116 Smith St
Apt 4F
Brooklyn, NY 11201-4347

Phone

(917) 846-0849

NPI assigned

May 16, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Functional Coaching LLC

  • Early Intervention Provider Agency
  • Brooklyn, NY
  • NPI 1134013485
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463356800000",
    "number": "1275980617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 SMITH ST",
            "address_2": "APT 4F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 SMITH ST",
            "address_2": "APT 4F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014347",
            "telephone_number": "917-846-0849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGMAN",
        "first_name": "MOLLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-16",
        "last_updated": "2016-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "020420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen Catherine Wageman, LCSW
• Kadejatou Waggeh
• Roxanne Christine Waggoner, DO
• Sharvari Wagh
• Bhupendra P Wagley, MD
• Alexis Wagner, RRT
• Aviva Wagner
• Cheri Wagner
• Courtney Cimone Wagner, LMHC
• Jessica Wagner

• Early Intervention Provider Agency in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Early Intervention Provider Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.