Individual
AUSTIN AGBONIFO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
36 WESTMINSTER CT APT E36, ROXBURY, MA 02119-1192
(857) 498-4939
Mailing address
36 WESTMINSTER CT APT E36, ROXBURY, MA 02119-1192
(857) 498-4939
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2312537
MA
Other
Enumeration date
11/18/2019
Last updated
01/29/2024
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