Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Samantha Rose Wagner, MACCC-SLPTSSLD

Individual provider Speech-Language Pathologist · NPI 1053185405

Samantha Rose Wagner, MACCC-SLPTSSLD is a Speech-Language Pathologist in Long Island City, New York. Licensed in New York. Registered with an NPI since 2023.

Licensed in
NY
In the registry since
2023

Practice location Address checks out

4829 37th St
Long Island City, NY 11101-1903
Phone: (646) 621-1320
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 033514 (NY)

Record details

NPI number1053185405
Entity typeIndividual (Type 1)
GenderFemale
Credentials MACCC-SLPTSSLD
Sole proprietorNo
NPI enumeratedNovember 7, 2023
Last updated in NPPESMay 2, 2024
Certification dateMay 2, 2024

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