Doctor Name: | JAMES V AGRESTI |
NPI Number: | 1255389813 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | XA9072240 |
Business Practice Address: | 181 Franklin Ave #201 Nutley, NJ - 071103820 |
Business Phone Number: | 9732840777 |
Business Fax Number: | 9732841530 |
Mailing Address: | 66 Somme St, NEWARK |
State: | NJ |
Postal Code: | 071053612 |
Phone Number: | 9735220006 |
Fax Number: | 9735220666 |
NPI Enumeration Date: | 05/05/2006 |
NPI Last Update Date: | 07/07/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207RA0401X |
License Number: | XA9072240 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NJ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Internal Medicine |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |