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NPI Code Detail

MEDICARE: AGILE URGENT CARE OF SECAUCUS LLC

MEDICARE: AGILE URGENT CARE OF SECAUCUS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM1300XMulti-Specialty Clinic/Center
2261QR0401XComprehensive Outpatient Rehabilitation Facility (CORF)

General Provider Information

NPI Number : 1720911225
Entity Type Code : Organization
Provider Name (Legal Business Name) : AGILE URGENT CARE OF SECAUCUS LLC
Provider Business Mailing Address
First Line : 20 MEADOWLANDS PKWY STE 2
Second Line :
City : SECAUCUS
State : NJ
Zip : 07094-2944
Country : US
Telephone Number : 201-762-5710
Fax Number :
Provider Business Practice Location Address
First Line : 20 MEADOWLANDS PKWY
Second Line :
City : SECAUCUS
State : NJ
Zip : 07094-2944
Country : US
Telephone Number : 201-381-4800
Fax Number :
Authorized Official
Title or Position : CEO
Name : SAIFULLA KHALED CHAUDHARY
Credential :
Telephone Number : 973-262-2909
Provider Enumeration Date : 06/04/2026
Last Update Date : 06/11/2026

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