Provider Demographics
NPI:1033270129
Name:AGRESTI PSYCHIATRIC CONSULTANTS
Entity Type:Organization
Organization Name:AGRESTI PSYCHIATRIC CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRISTS
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:AGRESTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-842-9550
Mailing Address - Street 1:2151 45TH ST
Mailing Address - Street 2:STE 207
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2026
Mailing Address - Country:US
Mailing Address - Phone:561-842-9550
Mailing Address - Fax:561-842-9114
Practice Address - Street 1:2151 45TH ST
Practice Address - Street 2:STE 207
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2026
Practice Address - Country:US
Practice Address - Phone:561-842-9550
Practice Address - Fax:561-842-9114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Not Answered314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK4871Medicare ID - Type Unspecified