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Individual
DR. NICODEME WANKO AGASSY
Active
Individual
DR. NICODEME WANKO AGASSY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
1026325
MA
2085R0202X
Diagnostic Radiology Physician
W5615
TX
208D00000X
General Practice Physician
25MA11170500
NJ
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/23/2018
Last updated
06/04/2026
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