AGELESS MEN'S HEALTH – NPI #1235581430
Clinic/Center

AGELESS MEN'S HEALTH is an AHC clinic located in STATEN ISLAND, NY. NPPES has assigned the NPI number 1235581430 to AGELESS MEN'S HEALTH on July 12, 2016. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “AGELESS MEN'S HEALTH” is a dba name, the actual legal business name for this organization is AGELESS MEN'S HEALTH HOLDINGS, PC CA. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QP2300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Primary Care

The NPI profile was last updated on Nov 11, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for AGELESS MEN'S HEALTH below.

NPI Profile for
AGELESS MEN'S HEALTH HOLDINGS, PC CA

NPI Number
1235581430
Enumeration Date

(about 10 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
AGELESS MEN'S HEALTH HOLDINGS, PC CA
Doing Business As (dba): AGELESS MEN'S HEALTH
Primary location
78 TODT HILL RD STE 205
STATEN ISLAND, NY 10314-4528
Phone: (212) 837-1946 Fax: (212) 837-1908
Mailing address
1847 VICTORY BLVD
LOWER LEVEL
STATEN ISLAND, NY 10314-3550
Phone: (212) 837-1946 Fax: (212) 837-1908
Organization Subpart
No
Authorized Official
AMANDA WILKINSON
BUSINESS OPERATIONS DIRECTOR
Phone: (702) 818-0446
Updated
Certification Date
Nov 11, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QP2300X
- Clinic/Center / Primary Care (Primary)
174400000X
- Specialist

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.