MEDICARE: AG URGENT CARE, P.C.

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
1	261QP2300X	Primary Care Clinic/Center	201140	NY
2	261QM2500X	Medical Specialty Clinic/Center
3	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	201140	NY
4	261QM1300X	Multi-Specialty Clinic/Center	201140	NY
5	261QE0002X	Emergency Care Clinic/Center
6	261QU0200X	Urgent Care Clinic/Center	201140	NY

General Provider Information

NPI Number	:	1992116701
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AG URGENT CARE, P.C.

Provider Business Mailing Address
First Line	:	1295 BROADWAY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11221-2973
Country	:	US
Telephone Number	:	718-975-2270
Fax Number	:	718-975-2271

Provider Business Practice Location Address
First Line	:	1295 BROADWAY STE 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11221-2973
Country	:	US
Telephone Number	:	718-975-2270
Fax Number	:	718-975-2271

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. THEOPHINE ABAKPORO
Credential	:	M.D.
Telephone Number	:	718-975-2270

Provider Enumeration Date	:	05/14/2014
Last Update Date	:	05/12/2026

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