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Individual

JAMES V AGRESTI III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
181 FRANKLIN AVE, #201, NUTLEY, NJ 07110-3820
(973) 284-0777
(973) 284-1530
Mailing address
66 SOMME ST, NEWARK, NJ 07105-3612
(973) 522-0006
(973) 522-0666

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA0726100
NJ
207RA0401X
Addiction Medicine (Internal Medicine) Physician
XA9072240
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0079588
NJ
Enumeration date
05/05/2006
Last updated
07/07/2011
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