Provider Demographics
NPI:1790874311
Name:AGNELLO, JOSEPH THOMAS (PT, MDT)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:THOMAS
Last Name:AGNELLO
Suffix:
Gender:M
Credentials:PT, MDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5141 BRIGHTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-2743
Mailing Address - Country:US
Mailing Address - Phone:412-831-1220
Mailing Address - Fax:412-831-1663
Practice Address - Street 1:5141 BRIGHTWOOD RD
Practice Address - Street 2:
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-2743
Practice Address - Country:US
Practice Address - Phone:412-831-1220
Practice Address - Fax:412-831-1663
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT006464L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA670776OtherHIGHMARK
PA670776OtherHIGHMARK