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Individual

DANIEL DOMINICK AGNESE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT, CSCS

Contact information

Practice address
310 TAUGHANNOCK BLVD STE 1C, ITHACA, NY 14850-3251
(607) 252-3500
(607) 252-3505
Mailing address
310 TAUGHANNOCK BLVD STE 1C, ITHACA, NY 14850-3251
(607) 252-3500
(607) 252-3505

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
030031-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00332729
NY
Enumeration date
06/01/2010
Last updated
06/01/2010
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