Individual
JONATHAN AGOSTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AUD
Contact information
Practice address
36 NEWARK AVE STE 130, BELLEVILLE, NJ 07109-4120
(973) 528-2690
(973) 302-4074
Mailing address
36 NEWARK AVE STE 130, BELLEVILLE, NJ 07109-4120
(973) 528-2690
(973) 302-4074
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
41YA00106700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41YA00106700
STATE OF NJ
NJ
Enumeration date
09/27/2019
Last updated
09/27/2019
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