Provider Demographics
NPI:1922328749
Name:AGUGLIA, TIMOTHY P
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:P
Last Name:AGUGLIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 PAMELA CT
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-4713
Mailing Address - Country:US
Mailing Address - Phone:716-675-0779
Mailing Address - Fax:
Practice Address - Street 1:24 WESTMINSTER AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-1614
Practice Address - Country:US
Practice Address - Phone:716-816-3450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013657-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist