MEDICARE: MAUREEN AGOGLIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	047532	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508047499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAUREEN AGOGLIA

Provider Business Mailing Address
First Line	:	599 E MAIN ST
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-8505
Country	:	US
Telephone Number	:	631-666-2246
Fax Number	:

Provider Business Practice Location Address
First Line	:	599 E MAIN ST
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-8505
Country	:	US
Telephone Number	:	631-666-2246
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2007
Last Update Date	:	11/19/2007

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Directions to “ MAUREEN AGOGLIA ” Practice Location

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