Justin Joseph Agustini, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

RTO000178 Issued in PA

Practice address

1324 N Church St
Hazle Township, PA 18202-9307

Phone

(570) 501-1808

Fax

(855) 635-6308

NPI assigned

Nov 13, 2013

Last updated

Nov 13, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1384300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384300800000",
    "number": "1043640972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 MOUNTAIN VIEW DR",
            "city": "NANTICOKE",
            "state": "PA",
            "postal_code": "186343603",
            "telephone_number": "570-814-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 N CHURCH ST",
            "city": "HAZLE TOWNSHIP",
            "state": "PA",
            "postal_code": "182029307",
            "telephone_number": "570-501-1808",
            "fax_number": "855-635-6308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUSTINI",
        "first_name": "JUSTIN",
        "middle_name": "JOSEPH",
        "credential": "LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-13",
        "last_updated": "2013-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RTO000178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Marie Addesa, MSN, CRNP, FNP-C
• Ann Andrasovich, MD
• Ara-Hazleton LLC (The Kidney Center of Greater Hazleton)
• Astute Diagnostics LLC
• Joshua Balliet, OTR/L
• Alexis Barker, PA-C

• Athletic Trainer in Hazle Township, PA
• Providers in Hazle Township, PA by specialty
• Athletic Trainer in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.