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NPI Code Detail

MEDICARE: MRS. ELEONORA AGRON PTA

MEDICARE: MRS. ELEONORA AGRON PTA
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 Assistant003934NY

General Provider Information

NPI Number : 1508079724
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELEONORA AGRON PTA
Provider Business Mailing Address
First Line : 6715 102ND ST APT 5J
Second Line :
City : FOREST HILLS
State : NY
Zip : 11375-2408
Country : US
Telephone Number : 718-275-3739
Fax Number :
Provider Business Practice Location Address
First Line : 883 65TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-4737
Country : US
Telephone Number : 718-283-8961
Fax Number : 718-283-8940
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2007
Last Update Date : 07/08/2007

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