Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 141538 | NY |
NPI | 1063580579 |
---|---|
Provider Name | Glenn F. Agoliati |
First Address | Poughkeepsie, NY 12601-1359 |
Second Address | Poughkeepsie, NY 12601-1359 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2006 |
Last Update Date | 18/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B14974 | (02) | NY |