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General NPI Number Information
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NPI Number | 1841735248
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Entity Type | Individual
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Provider Name | REGINE AGNANT
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Gender | Female
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Dates
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Enumeration Date | 12/21/2016
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Last Update Date | 12/21/2016
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Provider Practice Location Address
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Address Line | 110 E 59TH ST 8TH FLOOR SUITE 8B
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City | NEW YORK
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State | NY
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Zip | 10022-1304
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Country | US
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Telephone | 212-734-1353
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Fax |
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Provider Business Mailing Address
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Address Line | 99 CLENT RD B102
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City | GREAT NECK
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State | NY
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Zip | 11021-4900
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Country | US
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Telephone | 914-646-6500
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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 | F341067-1
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License Number State | NY
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