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General NPI Number Information
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NPI Number | 1275140766
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Entity Type | Individual
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Provider Name | TOLGONAY AGAMEZ-MORALES MSN-FNP
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Gender | Female
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Dates
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Enumeration Date | 09/28/2020
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 148 ENGLE ST STE 1
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-2582
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Country | US
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Telephone | 904-315-4095
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Fax |
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Provider Business Mailing Address
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Address Line | 114 SUSSEX ST APT 1D
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City | HACKENSACK
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State | NJ
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Zip | 07601-4148
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Country | US
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Telephone | 904-315-4095
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11008743
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ14851900
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License Number State | NJ
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