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General NPI Number Information
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NPI Number | 1710200928
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Entity Type | Organization
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Legal Business Name | KAREN E. AGERSBOG, D.O. ASSOCIATES, P.C.
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Dates
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Enumeration Date | 03/03/2010
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Last Update Date | 03/03/2010
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Provider Practice Location Address
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Address Line | 8815 GERMANTOWN AVE SUITE 14
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City | PHILADELPHIA
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State | PA
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Zip | 19118-2722
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Country | US
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Telephone | 215-248-2600
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Fax | 215-248-2606
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Provider Business Mailing Address
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Address Line | 8815 GERMANTOWN AVE SUITE 14
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City | PHILADELPHIA
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State | PA
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Zip | 19118-2722
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Country | US
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Telephone | 215-248-2600
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Fax | 215-248-2606
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. KAREN ELIZABETH AGERSBORG
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Credential | DO, FACOI, FACE
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Telephone | 215-248-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | OS010570L
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License Number State | PA
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