NPI 1083067722 · live from the CMS NPI Registry
Maryjo Agosta
Physician Assistant in Union, NJ. National Provider Identifier 1083067722, active.
NPI record
| NPI | 1083067722 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 1000 Galloping Hill Rd, Union, NJ 07083 |
| Practice phone | 908-522-6300 |
| Mailing address | 30 Roosevelt Ave, Chatham, NJ 07928 |
| Enumerated | July 18, 2016 |
| Last updated | July 18, 2016 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant primary | 363A00000X | 25MP00403100 (NJ) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.