Individual
BETH STACEY AGAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9 MAHAN RD, OLD BETHPAGE, NY 11804-1213
(516) 652-1230
Mailing address
9 MAHAN RD, OLD BETHPAGE, NY 11804-1213
(516) 652-1230
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
502622
NY
Other
Enumeration date
10/25/2023
Last updated
10/25/2023
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