Individual
JOHAN JINNETE AGOSTINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
264 BROAD ST APT 2, MERIDEN, CT 06450-5848
(203) 514-9100
Mailing address
264 BROAD STREET, APT. 2 REAR, MERIDEN, CT 06450
(203) 514-9100
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/05/2017
Last updated
07/21/2022
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