MEDICARE: ABIGAIL AGATON

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	225X00000X	Occupational Therapist	OC011130	PA

General Provider Information

NPI Number	:	1710271192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL AGATON

Provider Business Mailing Address
First Line	:	8 SADDLE WAY
Second Line	:
City	:	CHESTERFIELD
State	:	NJ
Zip	:	08515-2920
Country	:	US
Telephone Number	:	609-372-4658
Fax Number	:

Provider Business Practice Location Address
First Line	:	8 SADDLE WAY
Second Line	:
City	:	CHESTERFIELD
State	:	NJ
Zip	:	08515-2920
Country	:	US
Telephone Number	:	609-372-4658
Fax Number	:

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

Provider Enumeration Date	:	06/03/2011
Last Update Date	:	06/03/2011

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