Kevin Agostini, ATC, LAT

Individual provider Active NPI Athletic Trainer · Cheshire, CT

NPI 1699211540 · NPPES record last updated Jan 17, 2017

Key facts

NPI
1699211540
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
03534308 (CT)
Practice address
10 Main St
Cheshire, CT 06410-2403
Phone
(413) 884-2684
NPI assigned
Jan 17, 2017
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
03534308CTMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 03534308 CT Yes

Addresses

Primary practice location

10 Main St
Cheshire, CT 06410-2403

Mailing address

10 Main St
Cheshire, CT 06410-2403
Phone (413) 884-2684

Other providers in Cheshire, CT

All providers in Cheshire, CT · Athletic Trainer in Connecticut

Sources for this page

Verify at the official NPI Registry.