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NPI Code Detail

MEDICARE: CHRISTINE MARIE AGNELLO M.D.

MEDICARE:   CHRISTINE MARIE AGNELLO  M.D.
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
1207Q00000XFamily Medicine PhysicianMD052067LPA

General Provider Information

NPI Number : 1619919719
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE MARIE AGNELLO M.D.
Provider Business Mailing Address
First Line : 1700 PEACH ST STE 200
Second Line :
City : ERIE
State : PA
Zip : 16501-2134
Country : US
Telephone Number : 814-877-8140
Fax Number : 814-877-8141
Provider Business Practice Location Address
First Line : 1700 PEACH ST STE 200
Second Line :
City : ERIE
State : PA
Zip : 16501-2134
Country : US
Telephone Number : 814-877-8140
Fax Number : 814-877-8141
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2006
Last Update Date : 08/10/2021

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Directions to “ CHRISTINE MARIE AGNELLO M.D.” Practice Location

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