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Contact Information

AGEWELL DIAGNOSTICS, INC.
1999 MARCUS AVENUE
SUITE M15
LAKE SUCCESS, NY11042
 Phone: 516-488-8808
 Fax: 516-488-8808
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for AGEWELL DIAGNOSTICS INC · (Female)

NPI # 1366930836
Status Active
Credentials
Entity Individual
Enumeration date 04/30/2018
Last updated 04/30/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • NY License # 015532-1
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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