Leslie Wagner, MS,CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

012587-1 Issued in NY

Practice address

55 Tiemann PL
Apt # 55
New York, NY 10027-3332

Phone

(212) 662-7584

NPI assigned

May 11, 2007

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)

Enrolled

Credentials

Master of Science

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.

• Lifespire, Inc.

  • Clinic/Center
  • New York, NY
  • NPI 1497709166
  NPD (past)

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720293723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 TIEMANN PL",
            "address_2": "APT # 55",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100273332",
            "telephone_number": "212-662-7584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 TIEMANN PL",
            "address_2": "APT # 55",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100273332",
            "telephone_number": "212-662-7584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "LESLIE",
        "credential": "MS,CCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "012587-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan Wagner, MS, OTR
• Josh Wagner, DC
• Karen B Wagner, MD
• Kayla Wagner, CPNP-PC
• Lauren Wagner, MD
• Lisa Wagner, NP
• Lucy Wagner
• Lynda Jeanne Wagner
• Madlen Wagner
• Matthew John Wagner, DO

• Speech-Language Pathologist in New York, NY
• Providers in New York, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.