Provider Demographics
NPI:1275620247
Name:RAKOCZI, AGOTA EVA (PT)
Entity Type:Individual
Prefix:MRS
First Name:AGOTA
Middle Name:EVA
Last Name:RAKOCZI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HADLER DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-3320
Mailing Address - Country:US
Mailing Address - Phone:732-873-5484
Mailing Address - Fax:
Practice Address - Street 1:9 HADLER DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-3320
Practice Address - Country:US
Practice Address - Phone:732-873-5189
Practice Address - Fax:732-873-5189
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00706900174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist