Provider Demographics
NPI:1457068165
Name:AGULIS, DONNA J (RRT, RPSGT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:J
Last Name:AGULIS
Suffix:
Gender:F
Credentials:RRT, RPSGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08848-1812
Mailing Address - Country:US
Mailing Address - Phone:570-529-0105
Mailing Address - Fax:
Practice Address - Street 1:2125 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-3813
Practice Address - Country:US
Practice Address - Phone:610-810-4224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-02
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAYM012978227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered