Deborah Wagner PHD LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

35SI00358200 Issued in NJ

Legal business name

DEBORAH WAGNER PHD LLC

Practice address

1172 East Ridgewood Avenue
Suite #2
Ridgewood, NJ 07450-3928

Phone

(201) 445-3299

Fax

(201) 262-0425

NPI assigned

Jul 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Deborah Risku Wagner, PHD

Title

President Psychologist

Phone

(201) 445-3299

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801093745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1172 EAST RIDGEWOOD AVENUE",
            "address_2": "SUITE #2",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503928",
            "telephone_number": "201-445-3299",
            "fax_number": "201-262-0425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1172 EAST RIDGEWOOD AVENUE",
            "address_2": "SUITE #2",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503928",
            "telephone_number": "201-445-3299",
            "fax_number": "201-262-0425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBORAH WAGNER PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "RISKU",
        "authorized_official_title_or_position": "PRESIDENT PSYCHOLOGIST",
        "authorized_official_telephone_number": "201-445-3299",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35SI00358200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter De Cicco, L. AC
• Brian De Palma, MD
• Patricia Healy De Sear, PH.D
• Watutantrige Takshan Dealwis, M.D.
• Patricia Debartolome, LCSW
• Cathy Decarlo Pratola, M.S.W.
• Patricia Ann Decker, LAC
• Mary J Defranco, DPM
• Jeff Dejoseph
• Anthony Delfico, M.D.

• Psychologist in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.