MEDICARE: DR. DANIEL J AGONA DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC006465L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	828152	OTHER		PROVIDER

General Provider Information

NPI Number	:	1033199013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL J AGONA DC

Provider Business Mailing Address
First Line	:	1802 LINCOLN WAY
Second Line	:
City	:	WHITE OAK
State	:	PA
Zip	:	15131
Country	:	US
Telephone Number	:	412-678-3844
Fax Number	:	412-346-0203

Provider Business Practice Location Address
First Line	:	1802 LINCOLN WAY
Second Line	:
City	:	WHITE OAK
State	:	PA
Zip	:	15131
Country	:	US
Telephone Number	:	412-678-3844
Fax Number	:	412-346-0203

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	09/10/2014

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