Healthcare Provider Details

I. General information

NPI: 1720911225
Provider Name (Legal Business Name): AGILE URGENT CARE OF SECAUCUS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 MEADOWLANDS PKWY
SECAUCUS NJ
07094-2944
US

IV. Provider business mailing address

20 MEADOWLANDS PKWY STE 2
SECAUCUS NJ
07094-2944
US

V. Phone/Fax

Practice location:
  • Phone: 201-381-4800
  • Fax:
Mailing address:
  • Phone: 201-762-5710
  • Fax: 973-296-0696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State

VIII. Authorized Official

Name: SAIFULLA KHALED CHAUDHARY
Title or Position: CEO
Credential:
Phone: 973-262-2909