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General NPI Number Information
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NPI Number | 1891018420
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Entity Type | Organization
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Legal Business Name | JOSEPH AGNELLO MD PC
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Dates
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Enumeration Date | 03/10/2010
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Last Update Date | 03/10/2010
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Provider Practice Location Address
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Address Line | 1780 S BELLAIRE ST SUITE 230
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City | DENVER
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State | CO
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Zip | 80222-4307
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Country | US
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Telephone | 877-445-9052
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Fax | 877-445-9053
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Provider Business Mailing Address
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Address Line | 3130 SANFORD CIR
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City | LOVELAND
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State | CO
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Zip | 80538-4928
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Country | US
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Telephone | 877-445-9052
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Fax | 877-445-9053
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Authorized Official
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Title or Position | DIRECTOR
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Name | JOSEPH AGNELLO
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Credential | M D
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Telephone | 877-445-9052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 36493
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License Number State | CO
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