Individual
MRS. THERESA A AGOSTINELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.N.P.
Contact information
Practice address
900 ELMGROVE ROAD, ROCHESTER, NY 14624-6236
(585) 426-4100
(585) 426-3701
Mailing address
900 ELMGROVE ROAD, ROCHESTER, NY 14624-6236
(585) 426-4100
(585) 426-3701
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F3810951
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01725
BLUE SHIELD OF ROCHESTER
NY
05
—
01903277
—
NY
01
—
4129731
MVP
—
01
—
4334391
AETNA
—
01
—
NP0023
PREFERRED CARE
NY
01
—
P010164923
EXCELLUS
—
01
—
RC60164923
POMCO
—
01
—
Y028938
TRICARE REGION I
—
Enumeration date
10/19/2006
Last updated
02/04/2015
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