Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | MD027150L | PA |
NPI | 1043412802 |
---|---|
Provider Name | Mr. Frank John Dagostino |
First Address | Easton, PA 18045-2547 |
Second Address | Easton, PA 18045-2547 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2007 |
Last Update Date | 08/07/2007 |