Provider Demographics
NPI:1073318663
Name:AGATE, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:AGATE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:791 GARDEN DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-3924
Mailing Address - Country:US
Mailing Address - Phone:516-698-0043
Mailing Address - Fax:
Practice Address - Street 1:791 GARDEN DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-3924
Practice Address - Country:US
Practice Address - Phone:516-698-0043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027895-01225X00000X
NH3889225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist