Healthcare Provider Details

I. General information

NPI: 1689538985
Provider Name (Legal Business Name): EMANUEL AGAJ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 LINN AVE
YONKERS NY
10705
US

IV. Provider business mailing address

46 LINN AVE
YONKERS NY
10705
US

V. Phone/Fax

Practice location:
  • Phone: 646-464-0219
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number345391
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: