Provider Demographics
NPI:1316982689
Name:AGRIN, RICHARD J (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:AGRIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 LOUIS ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-2207
Mailing Address - Country:US
Mailing Address - Phone:732-545-1065
Mailing Address - Fax:732-545-1063
Practice Address - Street 1:137 LOUIS ST
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-2207
Practice Address - Country:US
Practice Address - Phone:732-545-1065
Practice Address - Fax:732-545-1063
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03341700207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0785407Medicaid
NJAG055319Medicare PIN
NJC60963Medicare UPIN