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Individual

DR. ENEIDA AGOSTO-COLON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3713 85TH ST BSMT, JACKSON HEIGHTS, NY 11372-7352
(718) 507-5400
(718) 507-5422
Mailing address
3713 85TH ST BSMT, JACKSON HEIGHTS, NY 11372-7352
(718) 507-5400
(718) 507-5422

Taxonomy

Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
211512
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02129564
NY
Enumeration date
10/06/2006
Last updated
06/19/2014
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