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NPI Code Detail

MEDICARE: DR. AGNES RADZIO MD

MEDICARE: DR. AGNES RADZIO 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
1208600000XSurgery Physician257216-1NY

General Provider Information

NPI Number : 1679530539
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AGNES RADZIO MD
Provider Business Mailing Address
First Line : 1441 SOUTH AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-3779
Country : US
Telephone Number : 718-494-1900
Fax Number :
Provider Business Practice Location Address
First Line : 1441 SOUTH AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-3779
Country : US
Telephone Number : 718-494-1900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2006
Last Update Date : 04/10/2024

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