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NPI Code Detail

MEDICARE: PARIS AGNEW

MEDICARE: PARIS AGNEW
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
1225200000XPhysical Therapy AssistantTEI004952PA

General Provider Information

NPI Number : 1285309559
Entity Type Code : Individual
Provider Name (Legal Business Name) : PARIS AGNEW
Provider Business Mailing Address
First Line : 82 PEACH ST
Second Line :
City : WESTVILLE
State : NJ
Zip : 08093-2113
Country : US
Telephone Number : 856-418-4883
Fax Number :
Provider Business Practice Location Address
First Line : 6400 GREENE ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19119-3231
Country : US
Telephone Number : 215-844-6400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2021
Last Update Date : 08/10/2021

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Directions to “ PARIS AGNEW ” Practice Location

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