Provider Demographics
NPI:1326346354
Name:D'AGOSTINO, HELENE E (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:HELENE
Middle Name:E
Last Name:D'AGOSTINO
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2017 DEER PARK AVE
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-2727
Mailing Address - Country:US
Mailing Address - Phone:631-586-4766
Mailing Address - Fax:
Practice Address - Street 1:79 SEQUOIA WAY
Practice Address - Street 2:
Practice Address - City:HOLBROOK
Practice Address - State:NY
Practice Address - Zip Code:11741-5606
Practice Address - Country:US
Practice Address - Phone:631-868-0625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF381821-1363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics