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General NPI Number Information
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NPI Number | 1144183153
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Entity Type | Organization
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Legal Business Name | AGAPE LIFE HEALTH NP IN PSYCHIATRY AND FAMILY HEALTH PLLC
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Dates
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Enumeration Date | 12/05/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 3534 AMBOY RD APT B2
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City | STATEN ISLAND
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State | NY
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Zip | 10306-2700
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Country | US
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Telephone | 718-607-1516
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Fax |
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Provider Business Mailing Address
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Address Line | 962 KATHLEEN CIR
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City | DANVILLE
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State | PA
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Zip | 17821-6469
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EMMANUEL AHIPUE
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Credential |
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Telephone | 718-607-1516
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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