Graduated: 1993
NPI: 1225697956
Practice Locations (2)
WAGNER MEDICAL PC
1400 HOOPER AVE, SUITE 2
TOMS RIVER, NJ 087532981
8666300966
SONDERMIND PROVIDER NETWORK LLC
110 TRADERS CROSS, FL 1
BLUFFTON, SC 299094637
8666300966
Source: CMS National Downloadable File, September 2026.