Allyson Agathis, MD

Individual provider Active NPI Pediatric Adolescent Medicine Physician · Bedminster, NJ

NPI 1487748513 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1487748513
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Adolescent Medicine Physician 2080A0000X
License
MA53611 (NJ)
Practice address
395 Main St
Bedminster, NJ 07921-2603
Phone
(908) 719-2626
Fax
(908) 719-2671
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA53611NJMDPediatric Adolescent Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X MA53611 NJ Yes

Addresses

Primary practice location

395 Main St
Bedminster, NJ 07921-2603

Mailing address

395 Main St
Bedminster, NJ 07921-2603
Phone (908) 719-2626

Other providers in Bedminster, NJ

All providers in Bedminster, NJ · Pediatric Adolescent Medicine Physician in New Jersey

Sources for this page

Verify at the official NPI Registry.