| Doctor Name: | MRS. TAMARA W. WAGER |
| NPI Number: | 1538445291 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 962 Luther Rd East Greenbush, NY - 120614015 |
| Business Phone Number: | 5182072065 |
| Business Fax Number: | 5182072069 |
| Mailing Address: | 962 Luther Rd, EAST GREENBUSH |
| State: | NY |
| Postal Code: | 120614015 |
| Phone Number: | 5182072065 |
| Fax Number: | 5182072069 |
| NPI Enumeration Date: | 10/26/2011 |
| NPI Last Update Date: | 10/26/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251300000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Local Education Agency (LEA) |
| Taxonomy Specialization: | |
| Taxonomy Definition: | The term local education agency means a public board of education or other public authority legally constituted within a State to either provide administrative control or direction of, or perform a service function for public schools serving individuals ages 0 |