NPI 1316559248 · live from the CMS NPI Registry
Agape Family Medical Center LLC
Nurse Practitioner, Family in Waterbury, CT. National Provider Identifier 1316559248, active.
NPI record
| NPI | 1316559248 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Family 363LF0000X |
| Practice location | 1078 W Main St Ste 3, Waterbury, CT 06708 |
| Practice phone | 860-797-0572 |
| Mailing address | 4 Woodland Trl, Ellington, CT 06029 |
| Enumerated | August 21, 2020 |
| Last updated | August 21, 2020 |
| Authorized official | Felistas Mazhandu, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Family primary | 363LF0000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.