AGILE INFUSION MEDICINE PC NPI 1972382018

NPI Information

NPI: 1972382018
Provider Name: AGILE INFUSION MEDICINE PC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 31D2298145

Address:
5 SUMMIT AVE STE 204
HACKENSACK, NJ
ZIP 07601
Phone: (201) 751-2202
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AGILE INFUSION MEDICINE PC is a primary care clinic center in Hackensack, NJ. AGILE INFUSION MEDICINE PC NPI is 1972382018. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5 SUMMIT AVE STE 204
HACKENSACK, NJ
ZIP 07601-271
Phone: (201) 751-2202
Fax: (201) 266-0437

The provider's authorized official is Jonathan Wiesen .
The authorized official title is Owner and has the following contact phone number (631) 759-9866.

The CLIA number assigned to this NPI record is 31D2298145 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/27/2023 and was last updated on 12/6/2023.

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	207RP1001X	Internal Medicine	Pulmonary Disease			No
2	261QP2300X	Clinic/Center	Primary Care			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: 5/5/2024

NPI Synchronization or Removal

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