Individual
AGNES DIGIACOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2600 POST RD, SOUTHPORT, CT 06890-1258
(203) 256-3338
(203) 256-3346
Mailing address
2600 POST RD, SOUTHPORT, CT 06890-1258
(203) 256-3338
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
000467
CT
231H00000X
Audiologist
41YA00061000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000467
LICENSE
CT
05
—
7121300
—
NJ
Enumeration date
06/10/2006
Last updated
01/31/2022
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