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General NPI Number Information
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NPI Number | 1235385089
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Entity Type | Organization
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Legal Business Name | AGYEMANG CLASSON MEDICAL P.C.
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Dates
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Enumeration Date | 08/12/2008
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Last Update Date | 08/12/2008
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Provider Practice Location Address
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Address Line | 753 CLASSON AVE SUITE L-L
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City | BROOKLYN
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State | NY
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Zip | 11238-4647
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Country | US
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Telephone | 718-789-1261
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Fax | 718-725-7307
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Provider Business Mailing Address
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Address Line | 533 S LONG BEACH AVE
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City | FREEPORT
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State | NY
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Zip | 11520-6109
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Country | US
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Telephone | 718-789-1261
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Fax | 718-725-7307
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KURAGU AGYEMANG
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Credential | M.D.
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Telephone | 718-789-1261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 192805
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License Number State | NY
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