| Agave Medical Nj Pc | |
|
359 5th St Unit 3 Jersey City NJ 07302-2329 | |
| (929) 209-6109 | |
| Not Available |
| Full Name | Agave Medical Nj Pc |
|---|---|
| Speciality | Psychologist |
| Location | 359 5th St Unit 3, Jersey City, New Jersey |
| Authorized Official Name and Position | Ori Fruhauf (OWNER) |
| Authorized Official Contact | 5513021794 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Agave Medical Nj Pc 359 5th St Unit 3 Jersey City NJ 07302-2329 Ph: () - | Agave Medical Nj Pc 359 5th St Unit 3 Jersey City NJ 07302-2329 Ph: (929) 209-6109 |
| NPI Number | 1619859238 |
|---|---|
| Provider Enumeration Date | 07/24/2025 |
| Last Update Date | 07/24/2025 |
| Certification Date | 07/23/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619859238 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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