AGAPE FAMILY MEDICAL CENTER LLC NPI 1316559248

NPI Information

NPI: 1316559248
Provider Name: AGAPE FAMILY MEDICAL CENTER LLC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 07D2192820

Address:
1078 W MAIN ST STE 3
WATERBURY, CT
ZIP 06708
Phone: (860) 797-0572
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AGAPE FAMILY MEDICAL CENTER LLC is a family nurse practitioner in Waterbury, CT. AGAPE FAMILY MEDICAL CENTER LLC NPI is 1316559248. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1078 W MAIN ST STE 3
WATERBURY, CT
ZIP 06708-651
Phone: (860) 797-0572

The provider's authorized official is Felistas Mazhandu .
The authorized official title is Owner and has the following contact phone number (860) 797-0572.

The CLIA number assigned to this NPI record is 07D2192820 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/21/2020 and was last updated on 8/21/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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