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General NPI Number Information
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NPI Number | 1700875846
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Entity Type | Individual
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Provider Name | MARC ADAM AGULNICK MD
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Gender | Male
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Dates
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Enumeration Date | 10/20/2005
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Last Update Date | 07/06/2009
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Provider Practice Location Address
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Address Line | 200 OLD COUNTRY RD SUITE 470
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City | MINEOLA
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State | NY
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Zip | 11501-4235
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Country | US
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Telephone | 516-739-9270
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Fax | 516-248-1727
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Provider Business Mailing Address
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Address Line | PO BOX 303
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City | FRANKLIN SQUARE
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State | NY
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Zip | 11010-0303
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Country | US
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Telephone | 516-739-9270
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Fax | 516-248-1727
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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 | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 230967-1
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License Number State | NY
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