Provider Demographics
NPI:1003125618
Name:AGNEW, AMY W (RN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:W
Last Name:AGNEW
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 WYGANT RD
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NY
Mailing Address - Zip Code:12542-5148
Mailing Address - Country:US
Mailing Address - Phone:845-236-4028
Mailing Address - Fax:845-236-4028
Practice Address - Street 1:15 JOYS LN
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-3705
Practice Address - Country:US
Practice Address - Phone:845-331-5064
Practice Address - Fax:845-331-0492
Is Sole Proprietor?:No
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY332804163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health