Individual
MS. AGNES L SO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
863 50TH ST, 2ND FL SUITE M5, BROOKLYN, NY 11220-6877
(718) 686-8880
Mailing address
863 50TH ST, SUITE M5, BROOKLYN, NY 11220-6877
(718) 686-8880
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
213474-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01988903
—
NY
Enumeration date
06/27/2006
Last updated
01/07/2021
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