Individual
MARYJO AGOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 GALLOPING HILL RD, UNION, NJ 07083-7989
(908) 522-6300
Mailing address
30 ROOSEVELT AVE, CHATHAM, NJ 07928-2548
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00403100
NJ
Other
Enumeration date
07/18/2016
Last updated
07/18/2016
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