Provider Demographics
NPI:1871030387
Name:AGATI, JOY
Entity Type:Individual
Prefix:MS
First Name:JOY
Middle Name:
Last Name:AGATI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 SHRUB HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-3100
Mailing Address - Country:US
Mailing Address - Phone:516-739-2913
Mailing Address - Fax:
Practice Address - Street 1:87 SHRUB HOLLOW RD
Practice Address - Street 2:
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-3100
Practice Address - Country:US
Practice Address - Phone:516-739-2913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-22
Last Update Date:2017-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003608101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health