Individual
AGNIESZKA LANTOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
256 MASON AVE, BLDG C, 3RD FLOOR, STATEN ISLAND, NY 10305-3408
(718) 226-6780
Mailing address
470 GOWER ST, STATEN ISLAND, NY 10314-6461
(917) 604-8657
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
011314
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03596229
—
NY
Enumeration date
05/08/2008
Last updated
08/08/2013
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