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General NPI Number Information
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NPI Number | 1275488447
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Entity Type | Individual
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Provider Name | AGU I UGWU
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Gender | Male
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Dates
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Enumeration Date | 03/03/2026
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Last Update Date | 03/04/2026
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Provider Practice Location Address
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Address Line | 1194 SEA ST APT 2
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City | QUINCY
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State | MA
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Zip | 02169-3557
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Country | US
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Telephone | 617-788-1065
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Fax | 617-830-8855
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Provider Business Mailing Address
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Address Line | 66 CANAL ST
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City | BOSTON
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State | MA
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Zip | 02114-2002
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Country | US
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Telephone | 617-788-1065
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Fax | 617-830-8855
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State | MA
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