Healthcare Provider Details

I. General information

NPI: 1932011814
Provider Name (Legal Business Name): AGAPEFORLIFE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2835 BAINBRIDGE AVE
BRONX NY
10458-2832
US

IV. Provider business mailing address

2835 BAINBRIDGE AVE
BRONX NY
10458-2832
US

V. Phone/Fax

Practice location:
  • Phone: 914-562-7101
  • Fax:
Mailing address:
  • Phone: 914-562-7101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. BETSI LUCIANO
Title or Position: FOUNDER & CEO
Credential:
Phone: 914-562-7101