Most Relevant Information
Provider Data
| NPI Number: | 1003462904 |
| Provider Name: | ELEXIS AGUNDEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 335832 |
Most Important Dates
| Enumeration Date: | 08/15/2019 |
| Last Updated: | 08/15/2019 |
Provider Practice Location
6 WILLIAMSBURG DR
NEWBURGH
NY
125503255
Practice Location Phone/Fax
| Phone: | 2098097615 |
| Fax: |
Provider Mailing Location
6 WILLIAMSBURG DR
NEWBURGH
NY
125503255
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |