| Doctor Name: | MS. JUDY WAGMAN |
| NPI Number: | 1073841516 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LICENSED CLINICAL SO |
| License Number: | R040316 |
| Business Practice Address: | 1142 Howard Dr Westbury, NY - 11590 |
| Business Phone Number: | 5163345453 |
| Business Fax Number: | 5163348843 |
| Mailing Address: | 1142 Howard Dr, WESTBURY |
| State: | NY |
| Postal Code: | 11590 |
| Phone Number: | 5163345453 |
| Fax Number: | 5163348843 |
| NPI Enumeration Date: | 11/20/2009 |
| NPI Last Update Date: | 11/20/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | R040316 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |