| Doctor Name: | MYRNA AGOSTO |
| NPI Number: | 1265563795 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P.P. |
| License Number: | 400605 |
| Business Practice Address: | 7520 Astoria Blvd East Elmhurst, NY - 113701131 |
| Business Phone Number: | 7188886788 |
| Business Fax Number: | 7185658302 |
| Mailing Address: | 13340 132nd St, SOUTH OZONE PARK |
| State: | NY |
| Postal Code: | 114203807 |
| Phone Number: | 7183221747 |
| Fax Number: | 7185658392 |
| NPI Enumeration Date: | 03/08/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0809X |
| License Number: | 400605 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health, Adult |
| Taxonomy Definition: | |