Agave Medical Nj PC
Psychologist in Jersey City, NJ. Organization (NPI-2).
NPI number1619859238
StatusActive
Last updated in NPPESJul 24, 2025
Details
- NPI
- 1619859238
- Entity type
- Organization (NPI-2)
- Legal business name
- Agave Medical Nj PC
- Organization subpart
- No
- Enumeration date
- Jul 24, 2025
- Certification date
- Jul 23, 2025
- Last updated
- Jul 24, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103T00000X | Psychologist | – | – | Yes |
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – |
Practice location
359 5th St Unit 3Jersey City, NJ 07302-2329
Phone 929-209-6109
Mailing address
359 5th St Unit 3Jersey City, NJ 07302-2329
Authorized official
Ori Fruhauf
Owner
5513021794
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