Provider Demographics
NPI:1053899351
Name:WARGO & ASSOCIATES, LLC
Entity type:Organization
Organization Name:WARGO & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:WARGO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN, A-GNP-C
Authorized Official - Phone:203-257-9503
Mailing Address - Street 1:66 ACORN RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-3340
Mailing Address - Country:US
Mailing Address - Phone:203-257-9503
Mailing Address - Fax:203-245-8943
Practice Address - Street 1:66 ACORN RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-3340
Practice Address - Country:US
Practice Address - Phone:203-257-9503
Practice Address - Fax:203-245-8943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-30
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7561363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty