Healthcare Provider Details

I. General information

NPI: 1740659408
Provider Name (Legal Business Name): AG CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2015
Last Update Date: 07/30/2023
Certification Date: 07/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 72ND ST APT 347
BROOKLYN NY
11209-2021
US

IV. Provider business mailing address

460 7TH AVE
BROOKLYN NY
11215-5514
US

V. Phone/Fax

Practice location:
  • Phone: 347-526-9442
  • Fax:
Mailing address:
  • Phone: 917-682-3652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number StateNY

VIII. Authorized Official

Name: PROF. ANDRES GOMEZ III
Title or Position: PRESIDENT
Credential:
Phone: 347-526-9442