Provider Demographics
NPI:1033247770
Name:WHITAKER, AGNES H (MD)
Entity Type:Individual
Prefix:
First Name:AGNES
Middle Name:H
Last Name:WHITAKER
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Gender:F
Credentials:MD
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Mailing Address - Street 1:15 W 72ND ST
Mailing Address - Street 2:SUITE 1P
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-3402
Mailing Address - Country:US
Mailing Address - Phone:646-692-8297
Mailing Address - Fax:646-692-8302
Practice Address - Street 1:15 W 72ND ST
Practice Address - Street 2:SUITE 1P
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-3402
Practice Address - Country:US
Practice Address - Phone:212-579-5557
Practice Address - Fax:212-579-5558
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2015-09-18
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Provider Licenses
StateLicense IDTaxonomies
NY1371092084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry