Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | 536 | CT |
NPI | 1093104770 |
---|---|
Provider Name | Dr. Sherline Agena |
First Address | Medford, NY 11763-1317 |
Second Address | E. Setauket, NY 11733 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2015 |
Last Update Date | 04/03/2020 |