AGELESS MEN'S HEALTH HOLDINGS PC CA NPI 1235581430

NPI Information

NPI: 1235581430
Provider Name: AGELESS MEN'S HEALTH HOLDINGS, PC CA

Doing Business As: AGELESS MEN'S HEALTH

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
78 TODT HILL RD STE 205
STATEN ISLAND, NY
ZIP 10314
Phone: (212) 837-1946
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AGELESS MEN'S HEALTH HOLDINGS, PC CA is a primary care clinic center in Staten Island, NY. AGELESS MEN'S HEALTH HOLDINGS, PC CA NPI is 1235581430. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Ageless Men's Health.

The provider's business location address is:

78 TODT HILL RD STE 205
STATEN ISLAND, NY
ZIP 10314-528
Phone: (212) 837-1946
Fax: (212) 837-1908

The provider's authorized official is Teah Michelle Smith .
The authorized official title is Credentialing Manager and has the following contact phone number (901) 205-3999.

The enumeration date for this NPI number is 7/12/2016 and was last updated on 11/13/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist				No
2	261QP2300X	Clinic/Center	Primary Care			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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