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General NPI Number Information
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NPI Number | 1639986870
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Entity Type | Organization
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Legal Business Name | AGAPE LIFE AND HEALTH, LLC
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Dates
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Enumeration Date | 12/11/2024
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 3534B AMBOY RD SUITE 2
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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 | 3534B AMBOY RD SUITE 2
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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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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | EMMANUEL AHIPUE
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Credential | DNP. PMHNP-BC, FNP-C
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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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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