MEDICARE: DR. CARMEN A NATALI-AGOSTINI MD

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	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician	25MA07309600	NJ
2	2084P0800X	Psychiatry Physician	168414	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	168414	OTHER	NY	HIP
2	25612866	OTHER	NY	UNITED
3	P-616-436	OTHER	NY	OXFORD
4	1172012	OTHER	NY	CIGNA
5	455303	OTHER	NY	VALUE OTIONS
6	255277	OTHER	NY	VALUE OPTIONS EMPIRE
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	7346352	OTHER	NY	GHI
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629062591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARMEN A NATALI-AGOSTINI MD

Provider Business Mailing Address
First Line	:	260 5TH AVE
Second Line	:	SUITE 12N
City	:	NEW YORK
State	:	NY
Zip	:	10001-6408
Country	:	US
Telephone Number	:	917-776-3496
Fax Number	:	212-685-5331

Provider Business Practice Location Address
First Line	:	900 SOUTH AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3425
Country	:	US
Telephone Number	:	718-732-7334
Fax Number	:	212-685-5331

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

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	09/11/2025

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