Individual ProviderAnne WagnerLicensed Practical NurseNursing Service ProvidersPractice Address660 N Dunton Ave, East Patchogue, NY 11772-4939(631) 286-7256PECOS EnrollmentBased on the most recent information from CMS, provider Anne Wagner does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1528373156Provider TypeIndividualFull NameWagner, AnneCredentialLPNGenderFemaleSole ProprietorNoEnumeration Date8/6/2010Last Updated8/6/2010Contact InformationPractice LocationPractice Address660 N Dunton Ave, East Patchogue, NY 11772-4939Phone(631) 286-7256FaxUnlisted FaxMailing LocationMailing Address660 N Dunton Ave, East Patchogue, NY 11772-4939Phone(631) 286-7256FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode164W00000XPrimaryDescriptionLicensed Practical NurseNursing Service ProvidersLicense226123New York