Healthcare Provider Details

I. General information

NPI: 1144651951
Provider Name (Legal Business Name): MARIA AGIATO PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2013
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 RESTONWOOD DR
APEX NC
27539-6218
US

IV. Provider business mailing address

109 RESTONWOOD DR
APEX NC
27539-6218
US

V. Phone/Fax

Practice location:
  • Phone: 516-426-6841
  • Fax:
Mailing address:
  • Phone: 516-426-6841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number268709
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: