Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | OS013656 | PA |
N | 111NI0900X | Internist | OS013656 | PA |
Y | 207RH0003X | Hematology & Oncology | OS013656 | PA |
NPI | 1063565042 |
---|---|
Provider Name | Dr. Nicole Marie Agostino |
First Address | Reading, PA 19612-3579 |
Second Address | West Reading, PA 19611-2143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2007 |
Last Update Date | 27/03/2018 |