Individual
LUCILLE D'AGOSTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5 LYON PL, OGDENSBURG, NY 13669-2586
(315) 393-2314
(315) 393-3873
Mailing address
214 KING ST, OGDENSBURG, NY 13669-1142
(315) 393-3600
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
346045
NY
363LF0000X
Family Nurse Practitioner
346045
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06505311
—
NY
Enumeration date
07/02/2020
Last updated
03/22/2022
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