Healthcare Provider Details

I. General information

NPI: 1992116701
Provider Name (Legal Business Name): AG URGENT CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2014
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1295 BROADWAY STE 1
BROOKLYN NY
11221-2973
US

IV. Provider business mailing address

1295 BROADWAY
BROOKLYN NY
11221-2973
US

V. Phone/Fax

Practice location:
  • Phone: 718-975-2270
  • Fax: 718-975-2271
Mailing address:
  • Phone: 718-975-2270
  • Fax: 718-975-2271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number201140
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number201140
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number201140
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number201140
License Number StateNY

VIII. Authorized Official

Name: DR. THEOPHINE ABAKPORO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 718-975-2270