Provider Demographics
NPI:1841794039
Name:BECKFORD, AGNIESZKA (RDH, THERAPIST)
Entity Type:Individual
Prefix:
First Name:AGNIESZKA
Middle Name:
Last Name:BECKFORD
Suffix:
Gender:F
Credentials:RDH, THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 EVERETT AVE
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-5504
Mailing Address - Country:US
Mailing Address - Phone:914-945-0889
Mailing Address - Fax:
Practice Address - Street 1:100 S HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-5634
Practice Address - Country:US
Practice Address - Phone:914-941-0825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024521124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty