MEDICARE: KAYLA AGENTOWICZ

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	225100000X	Physical Therapist	PT033876	PA

General Provider Information

NPI Number	:	1679436190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA AGENTOWICZ

Provider Business Mailing Address
First Line	:	446 ROUTE 106 APT D
Second Line	:
City	:	GREENFIELD TOWNSHIP
State	:	PA
Zip	:	18407-3904
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1095 TEXAS PALMYRA HWY STE 1
Second Line	:
City	:	HONESDALE
State	:	PA
Zip	:	18431-7687
Country	:	US
Telephone Number	:	570-616-0665
Fax Number	:	570-616-0665

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

Provider Enumeration Date	:	12/03/2025
Last Update Date	:	12/03/2025

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Directions to “ KAYLA AGENTOWICZ ” Practice Location

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