Provider Demographics
NPI:1144397803
Name:WAGREICH, SHARYN HEATHER (DC)
Entity Type:Individual
Prefix:DR
First Name:SHARYN
Middle Name:HEATHER
Last Name:WAGREICH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 5TH AVE RM 1505
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5049
Mailing Address - Country:US
Mailing Address - Phone:212-679-9270
Mailing Address - Fax:212-679-3826
Practice Address - Street 1:347 5TH AVE RM 1505
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5049
Practice Address - Country:US
Practice Address - Phone:212-679-9270
Practice Address - Fax:212-679-3826
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006443-1111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX53931Medicare ID - Type UnspecifiedMEDICARE NUMBER
NYU34509Medicare UPIN