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Dr. Nicodeme Wanko Agassy, MD
Student in an Organized Health Care Education/Training Program in New Brunswick, New Jersey
NPI 1477044550

Nicodeme Wanko Agassy is a Student in an Organized Health Care Education/Training Program based in New Brunswick, NJ. Nicodeme Wanko Agassy practices in New Brunswick, NJ and has the professional credentials of MD. The NPI Number for Nicodeme Wanko Agassy is 1477044550 and holds a License No. 25MA11170500 (New Jersey).

The current practice location address for Nicodeme Wanko Agassy is 1 Robert Wood Johnson Pl, New Brunswick, NJ and can be reached out via phone at 240-715-7885.

Location: 1 Robert Wood Johnson Pl, New Brunswick, NJ, 08901-4102
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1477044550
Provider Name
Nicodeme Wanko Agassy
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1 Robert Wood Johnson Pl, New Brunswick, NJ, 08901-4102
Phone Number
240-715-7885
Fax Number
Provider Enumeration Date
05/23/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1 Robert Wood Johnson Pl
City
New Brunswick
State
New Jersey
Zip
08901-1928
Phone Number
240-715-7885
Fax Number
person
Provider Business Mailing Address Details
Address
1 Robert Wood Johnson Pl
City
New Brunswick
State
New Jersey
Zip
08901-1928
Phone Number
240-715-7885
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
25MA11170500 (New Jersey)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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