Individual
AGNES GOSK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
518 E MAIN ST, RIVERHEAD, NY 11901-2529
(631) 369-1200
Mailing address
PO BOX 868, RIVERHEAD, NY 11901-0801
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508085226
—
NY
Enumeration date
06/27/2018
Last updated
06/27/2018
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